Anomalous aortic origin of coronary artery can lead to ischemia. Due to the limitations of invasive catheterization dobutamine stress testing, an alternative noninvasive approach is desired. A 65-year-old woman with atypical chest pain was referred for coronary computed tomography angiography. Although coronary artery disease was excluded, a right anomalous aortic origin of coronary artery with an interarterial and intramural course was discovered. The patient underwent invasive coronary angiography with a dobutamine stress test, which revealed a pathologic fractional flow reserve (ie, dobutamine fractional flow reserve) of 0.76 (normal >0.8) and lateral ostial compression in dobutamine intravascular ultrasound. A physical replication, using a patient-specific 3-dimensional-printed phantom was created based on coronary computed tomography angiography and evaluated in a flow loop under the same hemodynamic rest and stress conditions. The 3-dimensional-printed phantom fractional flow reserve was similar with 0.78, and dobutamine intravascular ultrasound showed comparable lateral compression.