Direct Aortic Interposition of Anomalous Left Anterior Descending Coronary Artery Without Cardiopulmonary Bypass

An anomalous origin of the left anterior descending (LAD) coronary artery arising from the pulmonary artery is a congenital malformation rarely described in adults. We describe the case of a 42-year-old man with this malformation who underwent an interposition of the LAD coronary artery to the ascending aorta with an off-pump technique. The clinical presentation, angiographic findings, and surgical treatment are discussed.