What is the role of aortography in routine diagnostic coronary angiography?

• A. To visualize the aorta and help identify aortic root anatomy before engaging coronaries
• B. To measure LV ejection fraction
• C. To check liver function
• D. To perform biopsy

Answer: (A)

Visualizing the aorta with contrast during routine diagnostic coronary angiography is done to outline the aortic root and ascending aorta so the operator can accurately engage the coronary ostia. Seeing the sinus of Valsalva and the sinotubular junction helps choose the appropriate catheter shape and approach, anticipate any anatomic variations, and minimize manipulation that could cause injury or compromise the catheter. It also allows assessment for aortic root dilation or atheroma that could affect catheter manipulation or embolize during the procedure.

Other options aren’t the goal of this step: LV ejection fraction is typically assessed with ventriculography or other imaging modalities, while liver function tests or biopsy are unrelated to coronary anatomy imaging and not performed as part of routine coronary angiography.