高晓红冠脉造影MicrosoftOfficePowerPoint97-2003幻灯片讲稿.pptVIP

常用动脉穿刺部位 足背动脉 肱动脉 股动脉 桡动脉 冠脉造影是将特殊的导管经大腿处股动脉或上肢桡动脉处穿刺后插至冠状动脉开口，选择性地将造影剂注入冠状动脉，记录显影过程，用以判断冠状动脉有无病变。?  回旋支 前降支 心肌的供血 左主干 正面观 右冠 1st 2nd 对角支 1st 2nd 钝缘支 心肌的供血 背面观 冠状静脉窦 右侧冠状动脉 后降支 ? ? 股动脉穿刺点 腹主动脉 首先穿刺股动脉或桡动脉，插入动脉鞘管，以方便操作造影导管。在X线透视下经鞘管插入造影导管至左（中图）、右冠状动脉开口（右图），推注在X线下可显影的造影剂 谢谢！ * * RIGHT CORONARY ARTERY The right coronary artery lies in a groove between the right atrium and right ventricle and loops around the lower side of the heart to the posterior side of the heart. It supplies blood and oxygen to the right atrium and right ventricle, the inferior wall of the left ventricle, and the posterior 1/3rd of the intraventricular septum. It also supplies the SA node in 55% of the population and to the AV node in 90% of the population. In 80% of the population, the RCA gives rise to the posterior descending coronary artery (PDA). This is known as “right dominance”. LEFT MAIN CORONARY ARTERY The left coronary artery system supplies blood to the muscle of the left ventricle. The left main divides almost immediately into two large branches: LEFT ANTERIOR DESCENDING (LAD) The LAD branch travels down the anterior wall of the left ventricle and supplies blood to approximately 2/3rds of the septum, the right buncle branch and the anterior superior division of the left bundle branch. It branches into the first and second diagonal arteries. It supplies the anterior portions of the septum, left ventricle, and right ventricle, as well as the apex. LEFT CIRCUMFLEX (LCX) The LCX branch travels in the atrioventricular groove to the posterior surface before it turns down the apex. It branches into first and second marginal arteries. It supplies the anterior left atrium, the lateral wall of the left ventricle, and the posterior left ventricle. It also supplies the AV node with blood in 10% of the population, the SA node in 45% of the population, and gives rise to the obtuse marginal branch. In 20% of the population, the LCX gives rise to the poster