The cardiology exams

THE CORONAROGRAPHY

- Description of the technique
- Conditions of exam
- Results
- Indications

In order to display the obstacle localized on the artery of the heart responsible for the infarct for example, it is necessary to analyse this artery but also the whole coronary arteries (heart arteries) during a radiological exam whose principle is to inject directly into the heart arteries a radiological product making a contrast visible on a x-ray.

The coronarography, literally meaning the “x-ray of the coronary arteries”, is an exam requiring to puncture an artery of a member in order to introduce a hose through which a product impervious to X-rays will be injected, directly into the coronary arteries.

This exam is generally painless. It lasts 15 to 20 minutes and its result is immediate.

The risks are relatively rare, about 3 to 5 complications for 1000 exams achieved, and correspond to a massive myocardial infarction, to cerebrovascular accidents, and to embolisms in the members.

DESCRIPTION OF THE TECHNIQUE

In order to inject this product into the coronary arteries, it is imperative to introduce a hollow hose up to their origin, i.e. into the aorta (artery coming out of the heart), practically at the level of the heart.

Thus, this hose is introduced through an artery (femoral or radial), then travels through the arterial network up to the aorta thus joining the origin of the coronary arteries.

- Putting the introductor in place

The first step of this work consists, after a local anaesthesia, to puncture an artery of a member in order to put a big calibre hose in place which constitutes an introductor.

The artery situated in the fold of the groin, the femoral artery, and the one situated at the level of the wrist (radial artery) is chosen to achieve this exam.

The introductor is put in place in the artery of the fold of the groin (femoral artery).

- Passing the hose through the introductor.

Once the introductor has been put in place in the artery (a generally painless gesture), the hose which will inject the radiological contrast product is introduced into the artery, then routed into the aorta up to the level of the starting point of the coronary arteries.

After having punctured the artery of the fold of the groin, the physician places a guide into the artery.

This hose will be placed at the origin of the coronary artery localized on the right side of the heart, then the radiological contrast product will be injected very quickly, in order to make this artery opaque. Concomitantly, a radiological film is made permitting to observe the whole right coronary artery.

Then, the hose is turned and placed at the origin of the left coronary artery. The sequences are then identical to those described for the right coronary artery.

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File last modified on june 7, 2006