Anomalili Koroner Olgularda Kateter Şekillendirmenin Anjiyografifik Görüntüleme Başarısındaki Rolü

Abstract

In this article, we present a case that suggesting some coronaries were not recognized in coronary angiography. On 2.6% of coronary angiograms anomalous origin of coronary arteries is encountered. In 0.58% of the cases left anterior descending artery (LAD) is arises from a separate ostium. Absence of LMCA can be discerned directly on coronary angiograms obtained using selective visualization of CX or LAD because in most of the cases of LAD and circumflex artery (CX) arise from separate ostia. A 54-year-old-female patient underwent coronary angiography through right radial route. In previous angiography performed at another center, The intermediate coronary (IM) artery was supposed to be the LAD and that was applied stent to the artery. We had watched the patient's previous angiography and we recorded various images considering that there may be another vessel in the new coronary angiography. Aortography was performed because the LAD area was empty in the left cranial view. When aortography is carefully examined, a weak image appears from a separate ostium, thought to belong to LAD. That could not be visualized using standard catheters. Using a 5F left Judkins catheter reshaped using a hot air gun LAD could be visualized selectively, and symptoms of the patient could be explained clinically. In patients who are undergoing coronary angiography where standard catheters can not be selectively engaged, in case of need, reshaping the catheter in the catheterization laboratory can be a practical, applicable method for the disclosure of occult coronaries.