Anomalous Right Coronary Artery Intervention Guided by Patient-Specific 3-Dimensional Printed Modeling

BACKGROUND: Percutaneous coronary intervention (PCI) of an anomalous aortic origin of a coronary artery (AAOCA) is technically challenging given difficult engagement and poor support. While coronary computed tomography angiography aids planning, it lacks the tactile simulation provided by patient-specific 3-dimensional (3D) modeling. CASE SUMMARY: A 58-year-old woman presented with recurrent angina and an anomalous right coronary artery originating from the left sinus. After repeated failures using conventional catheter selection, a 1:1 scale 3D-printed model was used for bench testing. This enabled the selection of an EBU 3.0 guiding catheter, leading to a successful PCI with 2 drug-eluting stents. DISCUSSION: This case demonstrates that 3D bench testing allows operators to anticipate support limitations and select optimal catheter geometry, potentially reducing procedure time and radiation. It highlights a structured alternative to empirical "trial-and-error" strategies in complex congenital anatomy. TAKE-HOME MESSAGE: Patient-specific 3D modeling facilitates successful PCI in AAOCA by enabling precise preprocedural simulation and optimal guiding catheter selection.