Application of CT-FFR in Congenital Anomalies of Coronary Artery

This chapter explores the application of coronary computed tomography-derived fractional flow reserve (CT-FFR) in evaluating congenital coronary anomalies, focusing on myocardial bridges (MBs) and anomalous origin of coronary arteries (AOCA). For MBs, CT-FFR demonstrates high diagnostic accuracy (sensitivity 96%, specificity 84%) in detecting hemodynamic ischemia, unaffected by MB depth, length, or stenosis severity, while predicting proximal atherosclerotic plaque formation. In AOCA, particularly interarterial right coronary artery anomalies, CT-FFR identifies functional ischemia linked to slit-like ostia, intramural courses, and dynamic compression. The integration of CT-FFR with coronary CT angiography offers noninvasive anatomical and physiological insights, enhancing risk stratification and guiding therapeutic decisions for these anomalies. Studies highlight CT-FFR’s potential to improve clinical outcomes by bridging anatomical assessments with functional significance in congenital coronary pathologies.