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This report describes the first saphenous vein bypass graft from the aorta to the left main coronary artery for an aberrant left main coronary artery arising from the anterior sinus of Valsalva. A 20-year-old college student had a cardiac arrest and documented ventricular fibrillation while jogging. He was resuscitated. An anomalous left main coronary artery, arising anteriorly from the right coronary sinus, was demonstrated at operation to be within the wall of the aorta. Following aorta--left main coronary artery bypass with the saphenous vein, results of a stress test were normal, and cardiac catheterization revealed the left coronary system to be entirely supplied by the graft.
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