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Coronary CT FFR vs Invasive Adenosine and Dobutamine FFR in a Right Anomalous Coronary Artery

Marius R Bigler1, Anselm W Stark1, Andreas A Giannopoulos2,3

  • 1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

JACC. Case Reports
|August 8, 2022
PubMed

Insights

This study details managing anomalous coronary arteries using advanced imaging like CT-FFR and invasive tests. Post-surgery, CT scans confirmed successful treatment outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Interventional Cardiology

Background:

  • Anomalous coronary artery origins, particularly from the contralateral sinus of Valsalva, pose diagnostic and therapeutic challenges.
  • Accurate assessment of hemodynamic significance is crucial for guiding management decisions.

Observation:

  • A comprehensive diagnostic workup was performed, integrating noninvasive coronary computed tomography (CT) derived fractional flow reserve (FFR) with invasive dobutamine-volume challenge-FFR and intravascular ultrasound.
  • This multi-modality approach allowed for detailed anatomical and functional evaluation of the anomalous coronary artery.

Findings:

  • Surgical correction was performed for the anomalous coronary artery.
  • Postoperative CT imaging provided both anatomical and functional assessment, confirming the success of the surgical intervention.

Implications:

  • This case highlights the utility of combining noninvasive and invasive techniques for precise diagnosis and management of complex coronary anomalies.
  • Successful surgical correction, verified by advanced imaging, offers a favorable prognosis for patients with this condition.

Keywords:
ACAOS, anomalous coronary artery originating from the opposite sinus of ValsalvaCCTA, coronary computed tomography angiographyCT, computed tomographyECG, electrocardiogramFFR, fractional flow reserveHR, heart rateanomalous coronary artery originating from the opposite sinus of Valsalvacomputational fluid dynamicscoronary computed tomography angiographyfractional flow reserve

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