CT-Derived Fractional Flow Reserve Guides Surgical Revascularization in Anomalous Long Left Anterior Descending With Curly-Q Intramyocardial Course.

ABSTRACT:

Background

Anomalous coronary arteries with intramyocardial courses pose diagnostic and management challenges.

Case summary

A 61-year-old woman with dyspnea, left bundle branch block, and reduced ejection fraction (25%) was found to have an anomalous long left anterior descending artery originating from the right coronary artery, coursing intramyocardially with a curly-Q configuration. Coronary computed tomography angiography revealed no obstructive disease, but computed tomography-derived fractional flow reserve showed a significant drop (0.78-0.79) distal to the curly-Q. This physiological assessment confirmed flow limitation, prompting a multidisciplinary decision to pursue coronary artery bypass grafting for revascularization. Postoperatively, the patient had symptomatic

SUBMITTER: Golec S 

PROVIDER: S-EPMC12665837 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature