Coronary Anatomy
Major Coronaries:
-Left main, LAD, LCx, RCA; L/R dominance
-When speaking about coronaries, try to list stenoses in above anatomical order
-CAD by definition, 50% diameter stenosis in one or more vessel
Projections:
-Coronaries best viewed from sides (LAO/RAO) and ends (cranial/caudal)
-First orient yourself:
*LAO will have spine+catheter on right/RAO spine on left
*Cranial will show the diaphragm/Caudal will not
*Try to name the view without looking at label
-Several views from different angles will be required
-Panning is useful to look for collateral flow
-Usually L. system shot first
Left System
RAO caudal usually first view
– it brings LAD to superior aspect of image
- Good view LCx (down center, perpendicular plane) and allows detection of Ramus
LAO Cranial
– LAD runs down the middle
- good separation of Diagonal branches
- Good view of a left-sided PDA
LAO caudal = “spider” view
-Great for viewing Left Main and proximal origins of LCx/Ramus and LAD
Right System
RAO Straight
-Most common view for RCA
-Good view of proximal and mid-RCA as well as right-sided PDA (bottom of image)
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Marco Perez , CCU 1/04