If the right ventricle is filling during a right coronary injection, what is the possibility?
Coronary cameral fistula draining into right ventricle.
Which is the most anterior artery visualised in the lateral view when an aortic arch injection is given?
The internal mammary arteries can be visualised within the sternal contour as a pulsatile darkening of the posterior rim of the sternum in the lateral view.
What are the types of catheters used for right ventricular angiography?
NIH catheter with no end hole and a few side holes and a balloon tipped Berman angiographic catheter are the usual catheters used for right ventricular angiography. In Berman angiographic catheter, since the balloon is at the tip, the holes are seen about one centimeter proximal to the tip of the catheter. If the balloon has been deflated prior to angiography, the pattern of dye efflux, originating about 1 cm proximal to the tip is suggestive of Berman angiographic catheter, while in the NIH catheter, the holes are quite near the tip, on the sides. Berman angiographic catheter being a flow directed catheter, is useful to enter the right ventricle in small infants with complex anatomy. NIH catheter being a stiffer catheter, may not be a good option in this situation.
Can a coronary artery fill from the right ventricular injection?
It can occur if the aorta is arising from the right ventricle or when there is a large ventricular septal defect. Another possibility is retrograde filling through the sinusoids in coronary cameral fistula from a coronary artery to the right ventricle. In this case the dye will be seen filling the sinusoids first and then the coronary branches followed by the main coronary artery. Prominent right ventricular sinusoids are seen in pulmonary atresia with intact ventricular septum.