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Left main coronary artery atresia (LMCAA) is a rare coronary anomaly. Usually they present with myocardial ischemia/infarction, heart failure, syncope due to ventricular arrhythmias or sudden death. Diagnosis is confirmed by CT or invasive coronary angiography. We are presenting two cases of LMCAA, who underwent off-pump coronary artery bypass surgery.