Coronary angiography right coronary artery: Difference between revisions
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==Overview== | ==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 via the right posterolateral branch. On coronary angiography, the RCA is easily recognizable as it appears like | 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. To expose the ostial and proximal part of the RCA, an LAO projection with caudal angulation is deployed. The distal segment of the RCA and the bifurcation into the posterior descending artery (PDA) may be exposed in an LAO cranial view coupled with deep inspiration. An AP projection with cranial angulation is required to completely expose the right posterolateral (RPL) branches of RCA. | ||
==How to Engage the Right Coronary Artery== | ==How to Engage the Right Coronary Artery== | ||
Revision as of 16:28, 25 August 2013
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. To expose the ostial and proximal part of the RCA, an LAO projection with caudal angulation is deployed. The distal segment of the RCA and the bifurcation into the posterior descending artery (PDA) may be exposed in an LAO cranial view coupled with deep inspiration. An AP projection with cranial angulation is required to completely expose the right posterolateral (RPL) branches of RCA.
How to Engage the Right Coronary Artery
The Right coronary artery (RCA) is engaged in the 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 30o 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 30o 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.
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.