Noninvasive Anatomical and Functional Imaging for Hemodynamic Relevance in Right Coronary Artery Anomalies

Can noninvasive anatomical and functional imaging accurately assess the hemodynamic relevance of right anomalous aortic origin of a coronary artery (R-AAOCA)?In this cohort study including 55 patients with R-AAOCA and interarterial/intermural course, coronary computed tomography angiography (CCTA) offered high sensitivity, and functional nuclear imaging demonstrated high specificity in predicting fractional flow reserve during dobutamine stress testing.Results suggest that stepwise application of a noninvasive imaging approach using first CCTA followed by optional nuclear cardiac imaging may reduce the need for invasive testing in R-AAOCA to a subset of patients.

Corresponding Author: Christoph Gräni, MD, PhD, Department of Cardiology, Inselspital University Hospital of Bern, University Hospital Bern, Freiburgstrasse 18, 3010 Bern, Switzerland (christoph.graeni@insel.ch).

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