Coronary anatomy: Difference between revisions
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'''Coronary anatomy and imaging planes''' | '''Coronary anatomy and imaging planes''' | ||
'''Aortic arch with its branches and internal mammary arteries''' | |||
[[File:Aortic arch.gif|thumb|none|400px| Aortic arch and its branches]] | |||
'''Aortic root''' | '''Aortic root''' | ||
The aortic root starts proximal of the SinoTubular Junction (STJ) which seperates the aortic sinuses from the tubular part (ascending aorta) (Fig 1). The right coronary artery has its ostium in the right coronary cusp. The left coronary artery has its ostium in the left coronary cusp (Fig 2). Note in the long axis view that both coronary arteries start just beneath the STJ. Because the aortic valve is somewhat tilted in the coronal plane the proximal part of the Right Coronary Artery (RCA) often runs a more downward course than the Left Main Coronary Artery (LMCA) which runs more horizontally. This effect is more pronounced when the ascending aorta and root are dilated. In these patients engaging the right coronary ostium in coronary angiography can sometimes be more difficult and require different catheters. | |||
[[File:Aortic root LA Image.jpg|thumb|none|400px|Fig 1: Long axis CT of aortic root]] | |||
[[File:Aortic root sa.jpg|thumb|none|400px|Fig 2: Short axis CT of aortic root]] | |||
'''Coronary arteries''' | '''Coronary arteries''' | ||
The two main coronary trunks lie in two perpendicular planes (Fig 1); The Right Coronary Artery | The two main coronary trunks lie in two perpendicular planes (Fig 1); The Right Coronary Artery and Left Circumflex Artery (LCX) run in the atrioventricular groove. The Left Anterior Descending (LAD) or Ramus Descendens Anterior (RDA) and Right Posterior Descending (RDP) run in the interventricular groove in de plane of the interventricular septum. In the standard Right Anterior Oblique (RAO) 30 we are looking down the plane of the AV-valves and have the LAD and the IVS running form left to right on the screen (Fig 2). In the Left Anterior Oblique 45 (LAO) projection we will be looking directly onto the AV-plane. | ||
[[File:699px-Heart_left_anterior_oblique_diagrams.svg.png|thumb|none|300px|Left anterior oblique view of the coronary arteries]] | |||
[[File: | [[File:1000px-Heart right anterior oblique diagrams.svg.png|thumb|none|300px|Right anterior oblique view of the coronary arteries]] | ||