Journal: JACC Case Reports
Article Title: Coronary CT FFR vs Invasive Adenosine and Dobutamine FFR in a Right Anomalous Coronary Artery
doi: 10.1016/j.jaccas.2022.06.009
Figure Lengend Snippet: Preoperative Diagnostic Assessment (A) Three-dimensional reconstruction of coronary computed tomography angiography (CCTA) illustrating the anomalous origin of the right coronary artery (RCA). (B1) CCTA of the right anomalous coronary artery originating from the opposite sinus of Valsalva (R-ACAOS) illustrating the intramural course. (B2) Depiction of the R-ACAOS origin demonstrating the slitlike ostium at the beginning of the intramural course. (B3) Distal reference diameter of the RCA. (C) CCTA-derived fractional flow reserve (CT FFR). The CT FFR value right after the ostium was 0.89, further declining to 0.79 owing to the long intramural course with proximal narrowing and oval vessel shape. (D) Invasive coronary angiography with selective intubation of the R-ACAOS. White circle shows the location of the pressure sensor. (E) Invasive hemodynamic assessment, ie, FFR during dobutamine-volume challenge. LAD = left anterior descending (coronary artery); Pa = aortic pressure; Pd = distal pressure (measured by the pressure wire within the coronary artery).
Article Snippet: Furthermore, CT fractional flow reserve (FFR) (on-site software prototype cFFR, version 3.5.0 Siemens Healthineers) was performed and indicated a borderline hemodynamic relevance of the anomalous vessel (FFR = 0.79, threshold ≤0.80).
Techniques: Diagnostic Assay, Computed Tomography, Derivative Assay