Coronary Angiography Through the Eyes of the Interventional Cardiologist

If every heart sat in the chest at the same angle and each artery bifurcated at the same degree, then angiography would be a "cookie cutter" practice. Unfortunately, this is not the case, so angiography becomes more of an art, as we look to find the correct angle in order to decipher a 3-dimensional object in a 2-dimensional plane.

The purpose of the following presentation is to gain a better understanding of what the cardiologist is looking for ineach angle they take. Knowing how the angiogram should look will help the staff member suggest a good angle on that difficult anatomy. By gaining a better understanding of angiography, we are better able to reduce contrast load per case, reduce radiation exposure times, and reduce procedure times.

To assist in this educational effort, longtime friend and angiographer Dr. George Vetrovec, Professor of Medicine at the Medical College of Virginia at Virginia Commonwealth University, reviews a diagnostic angiogram from start to finish. Not so much to focus on the coronary anatomy, but to focus on what he is looking for in advance of taking each angiogram and why he chooses each sequence of angles.


Forward: Thomas H. Maloney, RT, RCIS, Richmond, Virginia

Presentation: George W. Vetrovec, MD, FACC, FSCAI, Professor of Medicine, Director of the Adult Cardiac Catheterization Laboratory, Virginia Commonwealth University Pauley Heart Center, Richmond, Virginia

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Comments

Very useful lecture; Some examples of streaming artifact would also be helpful. Also comments about staying on the pedal long enough to visualize collateral fill would be helpful. I review a lot of angiograms and compare them to CTA's and often wish that the angiography's had been less concerned about radiation and stayed on the pedal longer. Thanks for the work in preparing this, I think it was terrific.
Carter Newton M.D.

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