Anomalous left anterior descending coronary artery: malignant hospital course of a not so benign anomaly.

Anomalous origin of the left anterior descending coronary artery from the right sinus of Valsalva has been described as a benign anomaly. Typically it takes one of two courses, intraseptal or prepulmonic (though pre-aortic and retro-aortic courses also have been described). We describe the treatment of a patient with prepulmonic route and a malignant course before revascularization.