This document discusses angiographic projections and views used for imaging specific coronary artery segments and congenital heart diseases. It provides the standard angiographic views and degrees of angulation used for visualizing the left main, left anterior descending, circumflex, right coronary arteries, pulmonary arteries, and structures like VSDs and ASDs. The document also lists patient, angiographer, and equipment factors that can cause poor angiograms.

1. ANGIOGRAPHIC PROJECTIONS

2. NOMENCLATURE OF
ANGIOGRAPHIC VIEWS
• AP position
• RAO position
• LAO position
• Cranial position
• Caudal position

3. ANGIOGRAPHIC VIEWS FOR
SPECIFIC CORONARY ARTERY
SEGMENTS
• Left Main AP
LAO cranial
LAO caudal
• Proximal LAD LAO cranial
RAO caudal
• Mid LAD LAO cranial
RAO cranial
Lateral
• Distal LAD AP
RAO cranial
Lateral
• Diagonal LAO cranial
RAO cranial

4. • Proximal circumflex RAO cranial
LAO caudal
• Intermediate RAO caudal
LAO caudal
• Obtuse marginal RAO caudal
LAO caudal
RAO cranial
• Proximal RCA LAO
Lateral
• Mid RCA LAO
Lateral
RAO
• Distal RCA LAO cranial
Lateral
• PDA LAO cranial
• Posterolateral LAO cranial
RAO cranial

5. DEGREE OF ANGULATION
• Left Coronary Artery
LAO - 300
- 450
Cranial - 200
- 300
Caudal - 200
- 300
RAO - 300
- 450
• Right Coronary Artery
LAO - 300
- 450
Cranial - 150
- 200
RAO - 300
- 450

6. COMMON ANGIOGRAPHIC VIEWS
OF CONGENITAL HEART DISEASE
• Biplane cineangiography is require
• For VSD
LAO - 500
– 600
Cranial - 200
– 300
• For ASD (Hepatoclavicular angiographic view)
LAO - 500
– 600
Cranial - 200
– 300

7. • For transposition of great arteries(Laid
back angiographic view)
Steep AP caudal - 350
• Proximal branch pulmonary artery
anatomy
Steep AP cranial - 350

8. Causes of Poor Angiograms
• PATIENT FACTORS
Size
Movement
Hardware (Pacemaker, Harrison rods, multiple surgery with clips)
• Angiographer Factors
Poor catheter seating
Poor contrast injection
• Equipment Factors
X-ray generated problem
X-ray tube problem
Image intensifier problem

9. THANK YOU

10. THANK YOU