Aneurysms of the coronary arteries occur in 0.3% to 4.9% of angiograms
. Only 13 cases of left main artery (LMA) aneurysms have been reported
. Of these, three were treated by ligation of the aneurysm and coronar
y revascularization; the others by revascularisation alone. We report
the case of a 56 years old man presenting with unstable angina and pre
vious history of myocardial infarction. Coronary angiography confirmed
three vessels disease and the presence of an aneurysm of the LMA exte
nding to the proximal part of the left anterior descending artery (LAD
). The patient was treated with ligation of the aneurysm and total myo
cardial revascularization. The clinical and radiological features are
reviewed, and the surgical options considered.