Asymptomatic occlusion of the left main coronary artery by an aortic pseudoaneurysm

Extrinsic compression of the left main coronary artery is a rare cause of c oronary ischemia, We describe a 35-year-old Asian woman with complete asymp tomatic occlusion of the left main coronary artery by a large aortic pseudo aneurysm. She underwent repair of the pseudoaneurysm and coronary artery by pass grafting at the Mayo Clinic in Rochester, Minn, The differential diagn osis is discussed. Based on this patient's age and associated vascular lesi ons, we conclude that Takayasu arteritis was the most likely cause of her c ondition.