Catheter positions in congenital cardiac malformations

Biplane cineangiocardiograms were examined from a population of patients with diverse forms of congenital heart disease and examples were selected to illustrate catheter positions which may help define and elucidate the anatomy of simple and complex cardiac lesions. Familiarity with the appearance of these typical and atypical catheter positions may be of considerable aid in the course of hemodynamic study and in the evaluation of cineangiocardiograms. The editors suggest that each figure be evaluated as an unknown before reading the caption.

Congenital tricuspid stenosis treated by a palliative open operation. Report of a case

The case is presented of a patient with congenital tricuspid stenosis who was treated successfully by a palliative open operation. The preoperative diagnosis was tricuspid atresia. At operation, however, congenital tricuspid stenosis was detected and managed by commissurotomy.. The postoperative course was very good. Later, the associated ventricular septal defect (VSD), pulmonary annular stenosis, and probably the atrial septal defect (ASD) will be corrected. We emphasize the importance of diagnosing congenital tricuspid stenosis correctly, because of the possibility of operating upon the valve itself.

[Videodensitometric, angiocardiographic and hemodynamic examinations in corrected tetralogy of fallot]

In 38 children with typical tetralogy of Fallot recatheterization was performed 15 days to 410/12 years after correction. Their age ranged from 47/12 to 181/12 years and their weigh? 14;8 TO 54.4 KG. The biplane angiocardiograms were especially evaluated with respect to thcy to decrease from intraoperative to postoperative values. We did not find a parameter, determined during the operation, which can predict with certainty the operative result, found at the time of recatheterization. The peak pressure ration PRV/PLV seems to be most suitable but in an individual case one cannot rely on it. A diastolic murmur was heart postoperatively in 25 children, 9 of whom had a regurgitation index greater than 10%. In all 38 patients an infundibulectomy was performed, which in every case resulted in a disturbance of the contraction pattern (asynergy) of the right ventricular outflow tract. In the area of the ostium infundibuli small aneurysms were demonstrated in 50% of the cases. They were divided according to their angiographic appearance, the type of asynergy and their visibility on the two standard x-ray projections. In 11 children we observed incompletely resected muscle bundles of the infundibulum. Hemodynamically they were insignificant. Residual muscular infundibular stenoses, causing a pressure gradient, were observed in 8 cases. Aortal indentations of varying degree at the site of cannulation for the extracorporal circulation were present in 91%. In 13 patients an outflow tract reconstruction was necessary. In 8 children the patch was clearly identifiable as such. The necessity of recatheterization after correction of tetralogy of Fallot is discussed.

[Laevo-cardiography for the functional evaluation of the ventricle. I. The normal left ventricle]

The possibility of evaluating left ventricular function from lateral laevo-cardiogram has been investigated. A planimetric comparison of the end-diastolic and end-systolic areas of a normal left ventricle shows a 50 to 60% reduction of the systolic area, compared with the diastolic value. Assuming concentric contraction of the left ventricle, the systolic/diastolic reduction in area is proportional to the ejection fraction. This provides a measure for the quantitative evaluation of myocardial function.

Optimizing cinefilm

A system for improving the quality of cinefilm and for maintaining quality control is described. Objective criteria for contrast, resolution, and grain structure were established to measure the effects of varying X-ray dose, f-stop, development temperature, and selection of film and developer. We found that all variables nust be adjusted to maximize the viewing quality and that similar denisty curves can be achieved, independently of the choice of film and developer.

Blood flow measurements in the iliac arteries by an improved angiographic cinedensitometric technique

The blood flow of iliac arteries was measrued by means of an improved angiographic chindensitometric technique. This consists of cineradiographic recording of contrast injection into the iliac arteries, followed by optical analysis of the "washout" phase of the contrast material at selected sites. In 25 pateints without perpheral vascular disease, undergoing abdominal angiography for different reasons, the blood flow measruements in left iliac arteries were within the limits of 371-766 ml