冠脉解剖简析与冠脉造影体位解读.pptVIP

右前位（RAO）30o 观察RCA中段 谢 谢 RCA LCX LAD （1）近段RCA 30°LAO-30°CAU 30°RAO-30°CAU 90°LAO-30°CAU 45°LAO （4）近段LCX 30°RAO-30°CAU 60°LAO-30°CAU （7）近段LAD 30°LAO-30°CRA 30°RAO-30°CAU 60°LAO-30°CAU （2）中段RCA 45°LAO 30°RAO 90°LAO （5）钝缘支 30°RAO-30°CAU 60°LAO-30°CAU （8）中段LAD 60°LAO-30°CRA 30°RAO-30°CRA 90°LAO 60°LAO-30°CAU （3）远段RCA 30°LAO-30°CRA 90°LAO （6）远段LCX 30°RAO-30°CAU 60°LAO-30°CRA （9）远端LAD 30°RAO-30°CAU 45°LAO 60°LAO-30°CRA 理想的血管造影投照体位 知识回顾Knowledge Review * View used to engage catheters for the left coronary artery and to position balloons/stents in the LAD. Straightens the proximal circumflex artery. Separates the circumflex and OM. Separates LAD and diagonals (if principle diagonal is inferior to the LAD in the lateral view). Grossly foreshortens the left system. * This illustrates how the ribs “mimic” the right hand, therefore, is a RAO view. * Straightens the LAD, although proximal segment is usually foreshortened. Isolates origins of diagonal branches. One of the best views for diagonal branches. Left main is foreshortened but distal portion can often reveal stenosis. * View used to determine coaxial engagement of the guide catheter tip for the left coronary system. Known as “Spider View”. Used to visualize disease in the left main. Used to visualize origins of the LAD and the circumflex. Excellent view of all left proximal vessels. Should be used when any of the following exist Long left main and proximal LAD Multiple vessel overlap of proximal LAD Horizontal heart Grossly foreshortened left main in LAO cranial * This illustrates the RCA resembling a capital “C”, therefore, it is an LAO view. * This illustrates the RCA resembling a capital “L”, therefore, it is an RAO view. The PDA travels away from you in the RAO view. 冠状动脉的解剖简析及冠脉造影体位解读 右冠状动脉 (RCA) 右冠状动脉 起源 右冠窦(低于左冠起源) 走行 沿右AV沟绕向心十字交叉部， 发出PDA(85%)； 继续前行,在左房室沟发出PL。 支配心肌 支配25％－35％的左心室 右冠状动脉 其他分支血管 圆锥动脉（Conus A）：通常其起源非常近端，经过RV流出道向前向上行走，其方向指向LAD。 窦房结动脉（SAN A）：斜向后通过房间隔的上部和RA的前壁，供应窦房结。 右冠