Hello Sameer, Just a little bit of anatomy before I explain you the report. The largest vessel in the body is aorta that comes off the heart. There are two little areas at the origin of aorta that are called left and right sinuses of Valsalva. Normally, left main coronary artery (that normally supplies the left side of the heart) originates in the left sinus of Valsalva while the right main coronary artery starts at the right sinus of Valsalva. Now, back to your report. The report says that your left main coronary artery originates in the right sinus of Valsalva. This is an anomaly but it is not of a major concern. What really requires medical attention, is the location of the left main coronary artery between the aorta and pulmonary trunk. Aorta has strong pulsations that may keep the left main coronary artery under continuous compressions. This, in turn, may cause symptoms. So, your doctor will most probably address this issue. Now about the plaque in the LAD. Simply put plaque is a collection of bad cholesterol in the wall of a vessel. Plaques can be soft (consisting of fat), calcified (mainly consisting of calcium) and mixed. This will most probably be addressed by administering you medications that lower cholesterol or by advising life-style changes (depending on individual patient s needs). Absence of the stenosis means that the plaque does not narrow the lumen of the vessel. Hope this helps. Kind Regards