Coronary angiography right coronary artery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The right coronary artery (RCA) is a coronary artery with a single origin that bifurcates (branches) to supply the right ventricular free wall (the acute marginal branches) and the inferior wall of the left ventricle through the posterior descending artery and the posterolateral wall of the left ventricle via the right posterolateral branch. On coronary angiography, the RCA is easily recognizable as it appears like the letter C in the left anterior obliques (LAO) projection and appears like a letter L in the right anterior oblique (RAO) projection. There are three angiographic views of the RCA that are traditionally obtained to visualize teh proximal, mid and distal segments.

How to Engage the Right Coronary Artery

The Right Coronary Artery (RCA) is engaged in the 30^o left anterior oblique (LAO) position.

Optimal Views of the Right Coronary Artery

The following sequence of views is obtained as the gantry is swung from the 30^o position to the AP cranial position with cranial angulation to the RAO 30 position.

Proximal RCA

The proximal RCA including the ostium is best visualized in the LAO 30 view with no cranial or caudal angulation.

Bifurcation of the RCA

The bifurcation of the distal RCA where the right posterolateral artery and the posterior descending artery originate is best visualized using 30 ^o of cranial angulation and no right or left angulation (the anteroposterior (AP) 0 cranial 30^o view).

Mid RCA

The middle RCA is best visualized in the straight right anterior oblique (RAO) 30 ^oview.

RCA LAO View

Initial angiographic imaging of the RCA in the LAO 30 projection gives the best view of significant ostial and proximal RCA disease.

File:RCA LAO Cranial.png RCA LAO 30 CAU

RCA RAO View

The mid RCA is best visualized in the straight RAO 30 position.

RCA AP 0 Cranial 30 View

The bifurcation of the distal RCA and rPDA is best seen in the AP 0 Cranial 30 view with a small breath in.