Chronic total occlusion of left main coronary artery in a young man.

Chronic total occlusion of the left main coronary artery is rarely encountered in coronary angiography. Patients are at high risk of death because of its intimate association with massive anterior myocardial infarction. A 29-year-old man with no cardiac risk factors, presented with myocardial infarction and severe mitral regurgitation. Coronary angiography revealed chronic total occlusion of the left main coronary artery. He underwent coronary artery bypass grafting and mitral valve repair.