Anomalous left coronary artery: prepulmonic course


An anomalous coronary artery arising from the opposite sinus usually takes four common courses:

  1. interarterial (i.e. between the aorta and the pulmonary artery) - this is the most dangerous as it carries a high risk of sudden cardiac death (malignant course)
  2. retroaortic
  3. prepulmonic
  4. transseptal (subpulmonic)

In the case above, the course of the LAD is prepulmonic, and this is not a malignant course.