Unlocking the sealed entrance—exploring left coronary treatment options: a case report

This case represents the first reported surgical reconstruction of LMCA atresia using an EIA autograft. It highlights the limitations of ischaemia testing in congenital coronary anomalies, the potential advantages of reconstruction over conventional bypass surgery in the setting of competitive native flow, and the importance of individualized, thoughtful decision-making. External iliac artery autograft reconstruction may offer a promising alternative for patients with this rare condition.