INTRODUCTION Total occlusion of the left main coronary artery is a very rare finding in coronary angiography because of its highly lethal nature. Right coronary artery dominance and extensive collateral circulation are the principal determinant factors of survival after total occlusion of the left main coronary artery. The impact on the left ventricle is often significant with a profound alteration of its systolic function. CASE PRESENTATION We describe a 52-year-old North African man, a tobacco smoker, who presented symptoms of unstable angina related to a total chronic occlusion of his left main coronary artery with a right coronary artery stenosis. Unexpectedly, the impact on his left ventricle was absent with normal dimensions and systolic function. He underwent a successful on-pump coronary artery bypass grafting with uneventful postoperative course and good recovery. CONCLUSIONS Total occlusion of the left main coronary artery is a rare condition, the fact that the left ventricle retains a normal size and systolic function makes it exceptional, which must be kept in mind to avoid dangerous examinations and delayed treatment. Coronary artery bypass surgery should be considered the main treatment of total chronic occlusion of the left main coronary artery.

中文翻译：

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左主冠状动脉完全慢性闭塞和右冠状动脉狭窄后出乎意料的正常左心室收缩功能：一例病例并文献复习。

简介冠状动脉造影术中发现左主冠状动脉完全闭塞是非常罕见的发现，因为它具有很高的致死性。右冠状动脉占优势和广泛的侧支循环是左主冠状动脉完全闭塞后生存的主要决定因素。随着其收缩功能的深刻改变，对左心室的影响通常很明显。病例介绍我们描述了一名52岁的北非男子，一名吸烟者，他表现出不稳定的心绞痛症状，该症状与他的左主冠状动脉完全慢性闭塞以及右冠状动脉狭窄有关。出乎意料的是，正常尺寸和收缩功能对他的左心室没有影响。他接受了成功的泵上冠状动脉搭桥术，术后过程平稳，恢复良好。结论左主冠状动脉完全闭塞是一种罕见的疾病，左心室保持正常大小和收缩功能的事实使其异常，必须牢记这一点，以避免危险的检查和延迟的治疗。冠状动脉搭桥手术应被视为左主冠状动脉完全慢性阻塞的主要治疗方法。