New catheter design for cannulation of the anomalous right coronary artery arising from the left sinus of valsalva

Abstract

Cannulation of an anomalous right coronary artery during coronary angiography and percutaneous intervention poses significant technical difficulties using currently available catheter shapes. We describe a new catheter design and the cannulation technique for application of this catheter. The initial experience with this catheter in cases is reported.

Two Cases of Successful Primary Percutaneous Coronary Intervention in Patients With an Anomalous Right Coronary Artery Arising From the Left Coronary Cusp

“…Successful cannulation and optimal guiding catheter support depends on stable coaxial alignment, and the guiding catheter tip should be able to directly access the right anterior at a 45 to 90 degree angle. 11) There have been several case reports of successful cannulation of an anomalous RCA with using AL and Judkins 5 Left guiding catheters and manually manipulated guiding catheters such as a Leya catheter. [11][12][13][14] As in our two cases, we also could successfully cannulate the anomalous RCA with using a manually manipulated EBU guiding catheter and the recently developed Heartrail Ikari right 1.5 guiding catheter.…”

“…11) There have been several case reports of successful cannulation of an anomalous RCA with using AL and Judkins 5 Left guiding catheters and manually manipulated guiding catheters such as a Leya catheter. [11][12][13][14] As in our two cases, we also could successfully cannulate the anomalous RCA with using a manually manipulated EBU guiding catheter and the recently developed Heartrail Ikari right 1.5 guiding catheter. 15) When performing primary PCI, the operators and catheterization laboratories have to be aware of this anomaly and prepare specialized guiding catheters to facilitate PCI.…”

Coronary angiography and dual-source computed tomography are complementary methods in diagnosis of significant stenosis of the right coronary artery originating from the left aortic sinus

“…In the catheterization laboratory, the percutaneous intervention of the RCA originating from the left aortic sinus is a rare coronary procedure that is considered to be technically challenging, particularly with regard to proper guiding catheter support [6][7][8][9][10][11].…”

“…Recently, several case reports and small series described different types of guiding catheter modifications for facilitation of percutaneous interventions of anomalously originating RCA [6][7][8][9][10][11]. Usually, the catheter modifications are based on heating and reshaping of extra-support catheters (Voda or XB) or Amplatz left catheter.…”

“…Usually, the catheter modifications are based on heating and reshaping of extra-support catheters (Voda or XB) or Amplatz left catheter. The unusual modification of Amplatz left 2 catheter described by Qayyum et al [7] involves bending the catheter tip anteriorly and was named Leya catheter. We used a similar catheter design in our cases.…”