Suggested angiographic projections

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

General Terminology

• Rotation - describes the position of the image intensifier around the longitudinal axis of the patient. LAO refers to rotating the camera to the patient's left (catheter and spine will be on the right side of the image), RAO to the patient's right (catheter and spine on the left side of the image).
• Angulation - describes the position of the image intensifier in the short axis of the patient. Camera can pivit toward (cranial) or away (caudal) from the patient's head.

Diagram

Left Coronary Views

AP Cranial

• • LAD AP Cranial
  • LIMA to mid LAD

AP Caudal

AP Caudal

LAO Caudal

• • "spider" view, lays out the main branches of LMCA in a divergent manner, good look at bifurcation of LAD and Cx, origin of RI and origin of high OM brances. LAO Caudal
  • The LMCA and LAD are foreshortened.

LAO Cranial

• • Lays out the LMCA, proximal LAD, projects origin and trunks of the RI and 1st Dx to avoid overlap by the Cx. LAO Cranial

RAO Caudal

• • LMCA bifurcation, proximal LAD, proximal to mid Cx, origin and trunk of OM and left postero-lateral branch. RAO Caudal

RAO Cranial

• • Lays out LMCA, proximal LAD, proejcts origin and trunks of Ramus and 1st Dx to avoid overlap by proximal Cx. needs picture

Right Coronary Views

AP Cranial

• • RCA needs picture

LAO Cranial

• • Ostium, origin and proximal RCA, proximal acute marginal. needs picture
  • deep inspiration to clear diaphragm.
  • LAO - PDA and postero-lateral branches foreshortened, origin obscured by overlap, solved by cranial anguation.

RAO Cranial

• • Mid portions of the RCA, origin of acute marginal, septal perforators, length of PDL and postero-lateral branches. needs picture
  • Overlap of PDA and postero-lateral branches in RAO, solved by cranial angulation.

Post-surgical Views

• Left Lateral; LIMA (body)
• Right Cranial; LIMA to mid LAD
• Right Caudal; LIMA to distal LAD
• Left Lateral; LIMA to distal LAD
• Right Cranial; LIMA to diagonal arteries
• Left Lateral SVG to LAD

Resources

1. Schlant, R.; Wayne, A; Hurst's The Heart 8th Edition, McGraw-Hill, Inc. 1994

2. [3]

References

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