Invasive diagnostic coronary angiography

Summary

This chapter reviews the different stages a patient should go through once a coronary angiogram has been scheduled. It is important to clearly define up front what to expect from a coronary angiography and in which way the information gathered from the examination will help the operator for further therapeutic decisions making.

The pre-procedure evaluation as well as the post-procedure care of any patient is as important as the procedure itself. Besides the standard screening tests, special attention is focused on the group of patients for whom the examination carries a higher than normal risk for complications such as in the presence of diabetes, heart failure, chronic kidney disease, bleeding disorders.

Although watching a routine coronary angiogram performed by an experienced operator may look easy and straight forward, the fact is that it takes skills, knowledge of the coronary anatomy, insight into cardiac physiology and haemodynamic profiles, catheter material, action of drugs and above all experience.

A detailed description of each step of the procedure is discussed focusing in particular on catheter selection and the choice of optimal projections for each coronary segment.

The acquired data during the procedure, both anatomic and physiologic should be processed, if needed...