When you have completed review of this screen, please click the "Next
page" blue arrow for the second portion of this section. In the early days of cardiac catheterization,
The x-ray tube, image intensifier and camera remained stationary,
while the patient lay in a cradle that was rotated from the RAO to
the LAO projections. Cranial and caudal angulation were not possible
at those times. These "straight" AP view is limited because the density
of the spine interferes with the quality of the angiogram. However,
it may be of occasional value in displaying the origin and shaft of
the RCA. The right coronary artery (RCA) arises from
the anterior position of the right coronary cusp and travels in the
anterior atrio-ventricular (AV) groove. Often, the AV groove is seen
as a translucent stripe that gives a clue to its location.
The conus branch is usually the first branch,
and it travels to the right ventricular (RV) outflow tract. Occasionally,
the conus artery may have a separate origin from the RCA.
In 85% of cases the RCA travels to the cross-section of the
AV groove and the posterior inter-ventricular (IV groove). At this point,
it gives rise to the right posterior descending coronary artery branch
which travels in the posterior IV groove and gives rise to several septal
perforator branches (SP). The SP supply blood to the lower portion of
the IV septum.
When the RCA supplies the posterior descending
coronary artery, as it does in about 85% of cases, it is referred
to as a "DOMINANT" RCA. in the other 15% of cases, the circumflex
coronary artery supplies the PDA and is then called a "LEFT DOMINANT"
The RCA also gives rise to the AV nodal branch which supplies
blood to the AV node and the right postero-lateral (RPLA) branch which
supplies the lower postero-lateral portion of the left ventricle.
When you have completed
review of this screen, please click the "Next page" blue arrow for
the second portion of this section.