Art of Cannulating Coronary Arteries while doing Angiogram | Medicover Hospitals

Art of Cannulating Coronary Arteries while doing Angiogram | Medicover Hospitals

In this video, Dr. A.Sharath Reddy, senior interventional cardiologist, Medicover Hospitals, Speaks about the Art of Cannulating Coronary Arteries while doing angiograms. Firstly the diagnostic catheter is injected into the aorta. Then the catheter is pulled back gently, observing at the tip of the catheter. Once the pressure wave is checked, it is all ready to get injected. The number of views to be considered relies on the type of lesion. An epicardial view is taken, after which the patient is asked to take a deep breath by keeping the catheter in the left coronary sinus. A horizontal view of the left main coronary artery is taken, then an end face view is taken to make the cannulation process easy. Once the catheter is pulled back, the coronary engages to carry forward the process. This is the most traumatic way of engaging the left coronary artery, due to which an alternate procedure comes into action.
The guidewire should be coaxial to the artery. The usual problem at this stage is that the catheter enters the LMCA and obstructs. To avoid this, a smaller catheter is used. The catheter is rotated in the clock or anticlockwise direction to be aligned with the LID and then the views are determined after which the focus shifts to the right coronary artery to carry forward the cannulation process. Then the catheter is pulled out and rotated anticlockwise and it is brought to the level of RCA and rotated anticlockwise to keep it in place. Then the catheter is pulled back after the RAO view is determined. A non-selective sinus injection is taken, followed by which the catheter is moved onto the LCA and then is rotated in the anticlockwise direction. Three views are determined and the selection of the catheter is done. In this case, there was no problem observed with the cannulation.

Watch the video to know more!

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