Fig. 1: Summary of model development and evaluation throughout the entire study.

The model was developed using a retrospective dataset from the training and internal validation dataset and tested on a prospective cohort of the internal testing dataset from the same center. Models were then externally validated (external testing dataset). We finally simulated a real-world scenario using an unlabeled dataset (external clinical evaluation dataset). AAOCA Anomalous Aortic Origin of the Coronary Artery, CCTA coronary CT angiography, L-AAOCA left AAOCA, R-AAOCA right AAOCA.