Abstract
The right coronary artery (RCA) normally arises from the right aortic sinus of Valsalva, just below the sinotubular ridge. The ostium of the RCA is usually slightly lower than that of the LCA. Selective engagement of the RCA should be attempted in the straight LAO projection. In this view, the RCA ostium lies to operator’s left as he/she looks at the screen. The standard catheter for cannulation of the RCA is the Judkins right 4 (JR4) from either a transradial or transfemoral approach. The technique to engage a JR4 is to advance the catheter to just above the aortic valve then apply clockwise rotation whilst slowly withdrawing the catheter. This manoeuvre is harder than intubating the LCA and requires practice.
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References
Judkins MP. Selective coronary arteriography: a percutaneous transfemoral technique. Radiology. 1967;89:815.
Baim DS, Grossman W. Grossman’s cardiac catheterization, angiography, and intervention. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. chapter 11.
Recommended Reading
Zipes DP, Libby P, Bonow RO, Braunwald E. Braunwald’s heart disease: a textbook of cardiovascular medicine. 7th ed. Philadelphia: Elsevier Saunders; 2005. chapter 18.
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© 2016 Springer-Verlag London
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Curzen, N., Whittaker, A. (2016). Unable to Intubate the Right Coronary Artery. In: Lindsay, A., Chitkara, K., Di Mario, C. (eds) Complications of Percutaneous Coronary Intervention. Springer, London. https://doi.org/10.1007/978-1-4471-4959-0_7
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DOI: https://doi.org/10.1007/978-1-4471-4959-0_7
Publisher Name: Springer, London
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