The LCMA originates from the right coronary sinus. It travels in between the aorta and pulmonary artery, roughly in the plane of the valvular cusps of those vessels, compatible with a "malignant" variant of anomalous course, namely interarterial course of the left coronary artery. There is a roughly 50% non-atherosclerotic stenosis of the proximal LMCA in its interarterial path, due to extrinsic compression.
There is also a mild intra-stent stenosis of the mid- and distal RCA and CAD of the distal LMCA as well as LAD and LCx arteries.