An anomalous coronary artery arising from the opposite sinus usually takes four common courses:
- 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)
- transseptal (subpulmonic)
In the case above, the course of the LAD is prepulmonic, and this is not a malignant course.