Sample records for angiocardiography

  1. Quantitative radionuclide angiocardiography

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    Scholz, P.M.; Rerych, S.K.; Moran, J.F.; Newman, G.E.; Douglas, J.M.; Sabiston, D.C. Jr.; Jones, R.H.


    This study introduces a new method for calculating actual left ventricular volumes and cardiac output from data recorded during a single transit of a radionuclide bolus through the heart, and describes in detail current radionuclide angiocardiography methodology. A group of 64 healthy adults with a wide age range were studied to define the normal range of hemodynamic parameters determined by the technique. Radionuclide angiocardiograms were performed in patients undergoing cardiac catherization to validate the measurements. In 33 patients studied by both techniques on the same day, a close correlation was documented for measurement of ejection fraction and end-diastolic volume. To validate the method of volumetric cardiac output calcuation, 33 simultaneous radionuclide and indocyanine green dye determinations of cardiac output were performed in 18 normal young adults. These independent comparisons of radionuclide measurements with two separate methods document that initial transit radionuclide angiocardiography accurately assesses left ventricular function.

  2. Diagnosis of isolated dextrocardia using angiocardiography or surgery

    Institute of Scientific and Technical Information of China (English)

    马宁; 蒋世良; 黄连军; 赵世华; 徐仲英; 凌坚; 郑宏


    Background Isolated dextrocardia is a rare phenomenon and usually associated with multiple cardiac anomalies. This study was to evaluate the accuracy of diagnosis of isolated dextrocardia by using angiocardiography and to compare it with the results of surgery.Methods The clinical data of 27 cases of congenital isolated dextrocardia were collected to understand the diagnostic approaches to the major cardiac anomalies. All cases underwent angiocardiography followed by palliative or curative surgery. The diagnosis was compared by angiocardiography relying on segmental analysis with the pathological features observed in surgery.Results The results of angiocardiography of 22 patients were the same as the pathological features observed druing surgery, including one case with congenital left ventricular diverticulum was inadvertently omitted in angiocardiograhy. There were significantly dissimilar diagnoses between angiocardiograhy and post-operation in 5 patients, including anatomical corrected transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, complete transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, single ventricle misinterpreted as double-outlet right ventricle in 1, and anatomical double-outlet left ventricle misinterpreted as corrected transposition of the great arteries in 2. Misdiagnostic rate of angiocardiograhy was almost 20%.Conclusions Angiocardiography is of great significance in the diagnosis and classification of isolated dextrocardia. However, because of the intricacy of cardiac anomalies of isolated dextrocardia, atrial angiography and double oblique projection are needed to improve the accuracy of diagnosis to support surgical treatments.

  3. Pulmonary blood volume measured by RI angiocardiography

    International Nuclear Information System (INIS)

    RI angiocardiography (RACG) was performed in 81 patients with heart disease without congestive heart failure at the time, and the results were compared between the groups with mitral valve disease and other diseases. Cardiac output (CO) and pulmonary mean transit time (PMTT) were compared with the results from the dye dilution method in the same patients. PMTT directly measured by RACG was also compared with the peak to peak time (P-PT). P-PT was expressed as the distance from the right to the left peak time in radiocardiography (RCG). There were good correlations between the CO and PMTT obtained from the RI method and those of the dye dilution method (r = 0.90, r = 0.84). The ralationship between PMTT and P-PT in mitral valve disease was different from that of other diseases. The average value of PMTT was 5.2 +- 1.0 seconds, and pulmonary blood volume (PBV) was 315 +- 57 ml/m2 in the control group. The PBV values were markedly increased in patients with mitral stenosis (558 +- 132 ml/m2) and mitral regurgitation (444 +- 119 ml/m2), and were slightly increased in aortic valve disease, congenital shunt disease and cardiomyopathy. The patients with ischemic heart disease had normal PBV. In mitral valve disease, the direct method using PMTT of RACG is more accurate than the presumption method using P-PT of RCG. The determination of PBV by this method is very important to observe hemodynamic states in mitral valve disease. (J.P.N.)

  4. Radionuclide angiocardiography in the diagnosis of congenital heart disorders

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    Jones, R.H.; Austin, E.H.; Peter, C.A.; Sabiston, D.C. Jr.


    Radionuclide angiocardiography provides a noninvasive assessment of cardiac function and blood flow through the heart and lungs. During the past three years, this procedure has been used at the Duke University Medical Center for evaluation of 343 patients with congenital heart disorders. A review of this experience shows tat the resulting data were frequently useful in the surgical management of these patients. In patients with abnormal blood flow patterns, noninvasive imaging of blood flow was useful before and after operative correction. Radionuclide measurements of left-to-right intracardiac shunts were sufficiently accurate for use in the initial evaluation of patients with murmurs and to document the absence of shunt after operative closure of intracardiac septal defects. Moreover, measurements of right-to-left cardiac shunts were of benefit in the management of children with cyanotic heart disease. Measurements of left ventricular function obtained during rest and exercise were most useful in patients with origin of the left coronary artery from the pulmonary artery and in patients with congenital valvular insufficiency. This experience demonstrates that radionuclide angiocardiography provides important measurements of central hemodynamics and cardiac function which are useful in the management of patients with congenital heart disorders.

  5. Evaluation of radioisotopic angiocardiography in patent ductus arteriosus

    International Nuclear Information System (INIS)

    Dynamic images and curves obtained from radioisotopic angiocardiography (RI-ACG) using video recording system were studied in 5 patients with patent ductus arteriosus (PDA), to disclose any characteristic findings of PDA on this radioisotopic examination. And, the examination was evaluated with referance to diagnosis and assessment of status of PDA, comparing with other radiological examinations including angiocardiography and catheterization. Both the dynamic images and the dynamic curves of RI-ACG showed some characteristic findings of PDA, which was considered to be valuable to differentiate the intracardiac left to right shunt in atrial or ventricular septal defect. It was very characteristic of PDA that dynamic images showed regional dilution and recirculation patterns in the region of the main pulmonary artery to its periphery, and dynamic curves presented shunt waves on the descending limbs of the first circulation waves of both the pulmonary and the left ventricular region of interest. The Degrees of appearance of these characteristic findings showed a tendency to well correlate with the value of the left to right shunt fraction calculated by cathetelization technique. On the other hand, RI-ACG showed useful findings to diagnose pulmonary hypertension or heart failure associated with PDA. And, RI-ACG was very useful to detect an abrupt change of the central circulation dynamics in a patient with PDA, in whom continuous murmur characteristic of PDA desappeared intermittently. (author)

  6. Congenitally corrected transposition in the adult: detection by radionuclide angiocardiography

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    Guit, G.L.; Kroon, H.M.; Chin, J.G.; Pauwels, E.K.; van Voorthuisen, A.E.


    Congenitally corrected transposition (CCT) of the great vessels is an uncommon anomaly usually detected in children because of associated severe cardiac malformations. When these are absent, patients may be hemodynamically normal, but associated cardiac abnormalities are usually present in CCT, leading to symptoms in adulthood. When CCT is suggested in an adult, diagnosis by means of ultrasound may be difficult. Radionuclide angiocardiography (RA) is a simple, noninvasive method by which to diagnose CCT. The authors found consistent morphologic scintigraphic results in 13 patients with proved CCT, leading to establishment of reliable diagnostic criteria. In all instances of situs solitus the aorta ascends and descends on the left with vertical orientation. In the case of situs inversus, the aorta ascends and descends on the right with vertical orientation. The authors criteria are independent of the situs and cardiac position, unlike earlier reports by others. They believe images obtained in the anterior projection are sufficient for the study. The practical application of RA study in patient diagnosis is demonstrated, giving special attention to patients referred because of situs solitus and dextrocardia, in which CCT is known to be present in 50% of cases.

  7. Equilibrium radionuclide angiocardiography to select inotropic therapy in patients with left ventricular aneurysm

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    Maini, C.L.; Bonetti, M.G.; Antonelli Incalzi, R.; Pistelli, R.


    Fourteen patients with postinfarctual ventricular aneurysm underwent equilibrium radionuclide angiocardiography at rest (ERNA) before and after oral digoxin administration in order to evaluate the effects of increasing myocardial contractility upon both ventricular aneurysm mechanical behaviour and global ventricular function. The ejection fraction (EF) was not significantly affected by digoxin therapy. However, digoxin induced changes in EF ( correlated inversely with changes in aneurysm size and directly with changes in the extent of the hypokinetic area. Two types of aneurysm were obsered: a) high-compliance aneurysm the size of which increased after digoxin administration while both EF and the extent of the hypokinetic area fell, and b) low-compliance aneurysm for which opposite changes occurred. This different behaviour of ventricular aneurysm may have important practical implications as surgery would be probably more effective than medical treatment in improving resting ventricular function in patients with high-compliance aneurysm.

  8. Combined left and right ventricular volume determination by radionuclide angiocardiography using double bolus and equilibrium technique

    DEFF Research Database (Denmark)

    Stokholm, K H; Stubgaard, M; Møgelvang, J;


    by indicator dilution. The radionuclide technique comprised four steps: (1) a first-pass study of right ventricle; (2) a bolus study of left ventricle; (3) an equilibrium study of left ventricle; (4) determination of the distribution volume of red blood cells. Absolute volumes of left ventricle were determined......Eighteen patients with ischaemic heart disease were studied. Left and right ventricular volumes including cardiac output (forward flow) were determined by radionuclide angiocardiography using a double bolus and equilibrium technique. As reference, cardiac output was simultaneously measured...... from steps 2 + 3 + 4. Absolute volumes of right ventricle were calculated from stroke volume and right ventricular ejection fraction (EF) which in turn was determined from step 1 by creating composite systolic and composite diastolic images. There was an acceptable agreement between stroke volume...

  9. Basic studies on the estimation of the capacitance of human pulmonary 'venous' system using radionuclide angiocardiography

    International Nuclear Information System (INIS)

    To establish the methodology to assess the capacitance of human pulmonary 'venous' system, using radionuclide angiocardiography and passive leg elevation, some basic aspects of the method were investigated. The pulmonary 'venous' system consisted of pulmonary veins and the left atrium. A short segment of the volume-pressure curve in human pulmonary 'venous' system was obtained as a line connecting the 2 points. (1) Pulmonary 'venous' volume-mean pulmonary capillary wedge pressure plot (P 'V' V-PCW plot) in supine position, where P 'V' V=0.7 x PBV. Pulmonary blood volume (PBV) was obtained by radionuclide angiocardiography, while mean pulmonary capillary wedge pressure (PCW) was simultaneously recorded by a floating catheter. (2) ΔP 'V' V-ΔPCW relation where ΔP 'V' V=0.8 x ΔPBV. Increment of the pulmonary blood volume (ΔPBV) during passive elevation of legs was measured from the baseline PBV and the percentage increase in the radioactivity over the right anterior chest during the leg elevation, after correction for (a) radioactivity from chest wall origin, and for (b) attenuation of the radioactive beams by the lung and the anterior chest wall. ΔPCW was the increase in PCW during leg elevation. The present study focussed on the details of the two corrections, (a) and (b), using, in parts, mechanical models. The present study also focussed on the reproducibility of the ΔP 'V' V, ΔPCW and Cp'v' (compliance of the pulmonary 'venous' system). The coefficient of variation was ±23% in ΔP 'V' V, ±18% in ΔPCW and ±18% in Cp'v', indicating a fair degree of reproducibility. (author)

  10. Analysis of end-systolic pressure-volume relation by gated radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Left ventricular end-systolic pressure-volume relation has been proved experimentally to b e an useful index of left ventricular contractility relatively independent of preload or afterload. But less clinical application has been reported because of its invasive nature, and we evaluated this relationship non-invasively using gated radionuclide angiocardiography as volume determination and cuff sphyngomanometer in the arm as pressure measurement. Gated equilibrium blood pool scintigrams were obtained at rest and during intravenous infusion of angiotensin or nitrate. Ventricular volumes were derived from ventricular activity and peripheral blood volume and activity. The peak systolic pressure (PSP) by cuff method to end-systolic volume index (ESVI) relations showed good linearity (r gt .930 in 84% of consecutive 50 cases) and were gentler in the groups with more impaired left ventricular function. Emax was related exponentially to ejection fraction (EF) and hyperbolically to end-diastolic volume index. The dead volume (VoI) was unfixed and fell into positive or negative value, and was not related to EF under control condition. PSP/ESVI in each loading condition was less variable with the alteration of blood pressure than EF. The linear relation was found between PSP/ESVI under control condition and Emax (PSP/ESVI = 0.651.Emax + 0.958, r = 0.841, p lt .001). Thus in measuring ventricular volume, gated radionuclide angiocardiography is a non-invasive method less affected by the geometry of the left ventricle. Non-invasive determination of end-systolic pressure-volume relation using the volume by radionuclide and the blood pressure by cuff method is clinically useful in the assessment of left ventricular contractility. (author)

  11. Radionuclide angiocardiography in the clinical evaluation of cardiac malpositions in situs solitus in adults. (United States)

    Guit, G L; Kroon, H M; Chin, J G; Pauwels, E K; van Voorthuisen, A E


    A right-sided position of the heart in the chest in situs solitus is an abnormal feature easily discernible from a plain chest radiograph. This cardiac malposition may be due to cardiac displacement (dextroposition), which is usually a feature of lung disease, or a structural abnormality of the heart (dextrocardia). Because each condition has different clinical pathologic implications, it is important to distinguish them. Chest films, however, often provide no conclusive information. We performed radionuclide angiocardiography (RNA) in six adults with a cardiac malposition in situs solitus. It was found that morphologic data obtained from the serial images may distinguish dextroposition from dextrocardia. In addition, these images permitted us to diagnose congenitally corrected transposition, a cardiac anomaly which occurs with increased frequency in situs solitus with dextrocardia. Quantitative shunt detection performed during this procedure is helpful in the differential diagnosis of dextroposition and able to distinguish uncomplicated dextrocardia from dextrocardia associated with other cardiac abnormalities. RNA therefore is a valuable and easily performed method in the analysis of cardiac malpositions in adults.

  12. Measurement of shunt amount using radionuclide angiocardiography: accuracy according to level of shunt and associated lesion

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    Kim, Yang Min [Sejong General Hospital, Bucheon (Korea, Republic of)


    Determination of pulmonary to systemic blood flow ratio (QP/QS) is important for the management of patients with left-to-right shunt. This study was performed to assess the agreement of Qp/Qs ratio using the radionuclide method and oxymetry, to investigate the factors influencing the agreement, and to know how interchangeable the results of each technique. We compared the Qp/Qs measured by single-pass radionuclide angiocardiography and oxymetry during catheterization in 207 patients who underwent both studies. In radionuclide method, Qp/Qs was calculated from the pulmonary time-activity curves using a gamma variate fit. The correlation and Bland-Altman analysis were performed according to the levels of shunt and associated lesions. The mean Qp/Qs was 1.83 {+-} 0.50 by radionuclide, and 1.74 {+-} 0.51 by oxymetry. The overall correlation coefficient was 0.86 ({rho} 0.001), and Bland-Altman range of agreement encompassing 4SD was 1.05. For atrial septal defect, ventricular septal defect, patent ductus arteriosus, tricuspid and mitral insufficiency, the correlation coefficient was 0.78, 0.90, 0.84, 0.63 and 0.44 and Bland-Altman range was 1.52, 0.74, 0.96, 1.57 and 1.50, respectively. There is good agreement but wide variance between the Qp/Qs ratios by radionuclide method and oxymetry. Associated atrioventricular valvar insufficiency decreases the correlation coefficient and widens the variance. Wide overall variance suggests that Qp/Qs measurements by two techniques should not be used interchangeably.

  13. Right and left ventricular ejection fraction at rest and during exercise assessed with radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Right (RVEF) and left ventricular ejection fraction (LVEF) assessed with radionuclide angiocardiography were compared to simultaneously obtained catheterization results at rest and during exercise in patients with pulmonary hypertension and ischemic heart disease. Blood pool imaging was performed with red blood cells (RBC) labelled with 99Tcsup(m) in vivo as this method gave more stable 99Tcsup(m) levels in blood compared to 99Tcsup(m)-labelled human serum albumin and because it was more convenient than labelling RBC in vitro. RVEF measured with first pass (FP) technique and equilibrium (EQ) technique correlated well at rest, r = 0.86, and during exercise, r = 0.91. The FP technique had the best reproducibility and reference values at rest were 49+-5 per cent increasing with exercise. When 99Tcsup(m) and 133Xe were compared to assess RVEF with FP technique, the correlation was good, r = 0.88. LVEF assessed with EQ technique and a fixed end-diastolic region of interest was very reproducible at rest and during exercise; reference values at rest were 56+-8 per cent increasing with exercise. In 10 patients with pulmonary hypertension significant negative correlations were found between RVEF assessed with FP technique and pressures in pulmonary artery and right atrium. Abnormal RVEF was found in all patients with right ventricular disfunction. In 22 patients with recent myocardial infarction measurements of LVEF detected left ventricular disfunction better than did measurement of pulmonary artery diastolic pressure. During effort angina in another 10 patients all had abnormal LVEF and abnormal hemodynamics. By combining ejection fraction and stroke volume, ventricular volumes were calculated at rest and during exercise. (author)

  14. Non-invasive estimation of the human pulmonary blood volume with gamma camera and RI-angiocardiography

    International Nuclear Information System (INIS)

    A new, non-invasive method for the estimation of the human pulmonary blood volume (PBV), existing between the pulmonary artery bifurcation (PAB) and the left atrium (LA), has been developed in this laboratory, in the form of PBV = PPT sub(RCG) x 0.77 x CO, equation (6), given in Appendix. This was an extension of the classical Stewart-Hamilton method of indicator dilution, applied to radioisotope angiocardiography. Using a gamma-camera, the radio-isotope (99 m Tc-albumin) dilution curves were recorded externally at the region of PAB, LA and LV (left ventricle), among other things, in human subjects in supine position. The mean transit time (MTT) was determined for each region, and the difference in MTT, e.g., ΔMTT sub(PAB-LA), was measured. We calculated PBV between PAB and LA as PBV = ΔMTT sub(PAB-LA) x CO, equation (1) given in Appendix. Empirical time relations between ΔMTT sub(PAB-LA) and PPT sub(RCG) were examined in mechanical models and human subjects, through several steps represented by equations (2) to (5), given in Appendix, and our tentatively final formula was equation (6). The values of PBV estimated in this way were in good agreement with those of PBV measured invasively in the past, using two injection sites (PA and LA) and one sampling site (artery). (author)

  15. Non-invasive assessment of left ventricular contractility from end-systolic pressure-volume relation (E(max)) determined by gated radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Left ventricular end-systolic pressure-volume relation has been shown experimentally to be an useful index of left ventricular contractility relatively independent of preload or afterload. But the clinical application has been reported less frequently because of the invasiveness in the measurement of ventricular volume and simultaneous intraventricular pressure. We evaluated this relationship using non-invasive method such as the volume determination by gated radionuclide angiocartiography and the pressure measurement by cuff sphyngomanometer in arm. In measuring ventricular volume, gated radionuclide angiocardiography is a non-invasive method less affected by the geometry of left ventricle. Using the volume by radionuclide and the blood pressure by cuff, non-invasive determination of endsystolic pressure-volume relation provides much clinical usefulness in the assessment of left ventricular contractility

  16. Automatic 3D motion estimation of left ventricle from C-arm rotational angiocardiography using a prior motion model and learning based boundary detector. (United States)

    Chen, Mingqing; Zheng, Yefeng; Wang, Yang; Mueller, Kerstin; Lauritsch, Guenter


    Compared to pre-operative imaging modalities, it is more convenient to estimate the current cardiac physiological status from C-arm angiocardiography since C-arm is a widely used intra-operative imaging modality to guide many cardiac interventions. The 3D shape and motion of the left ventricle (LV) estimated from rotational angiocardiography provide important cardiac function measurements, e.g., ejection fraction and myocardium motion dyssynchrony. However, automatic estimation of the 3D LV motion is difficult since all anatomical structures overlap on the 2D X-ray projections and the nearby confounding strong image boundaries (e.g., pericardium) often cause ambiguities to LV endocardium boundary detection. In this paper, a new framework is proposed to overcome the aforementioned difficulties: (1) A new learning-based boundary detector is developed by training a boosting boundary classifier combined with the principal component analysis of a local image patch; (2) The prior LV motion model is learned from a set of dynamic cardiac computed tomography (CT) sequences to provide a good initial estimate of the 3D LV shape of different cardiac phases; (3) The 3D motion trajectory is learned for each mesh point; (4) All these components are integrated into a multi-surface graph optimization method to extract the globally coherent motion. The method is tested on seven patient scans, showing significant improvement on the ambiguous boundary cases with a detection accuracy of 2.87 +/- 1.00 mm on LV endocardium boundary delineation in the 2D projections.

  17. Evaluation of ECG gated RI angiocardiography for measurement of left ventricular function and its clinical application. Comparison with contrast cineangiography and application to pre and post treatment observation

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    Iida, Shun; Morishita, Takashi (Toho Univ., Tokyo (Japan). School of Medicine)


    Cardiac function was examined by the radio-isotope (RI) angiocardiography method in 57 patients with various heart diseases and 8 healthy subjects. In addition, the cardiac catheter examination was performed for comparison in 49 of the heart disease patients. After sup(99m)Tc-HSA was injected into the right antecubital vein by flush method, the electro-cardiogram was synchronized to obtain data. The data were analyzed with a computer and 9 parameters of the cardiac function were calculated: cardiac output (CO), ejection fraction (EF), pre-ejection period (PEP), left ventricular ejection time (LVET), left ventricular rapid filling time (LVRFT), left ventricular slow filling time (LVSFT), EF/LVET, EF/LVDT, and left ventricular end diastolic volume (LVEDV). When the RI method was compared with the cineangiogram, a significant correlation was found in all parameters: r = 0.728 (p < 0.01) in CO, r = 0.89 (p < 0.01) in EF, r = 0.825 (p < 0.001) in LVEDV, etc. Moreover, it is suggested that this method can be repeatedly applied to investigate the progress following an operation of the heart and the alteration of essential hypertension through drug treatment.

  18. Caudal Anaesthesia in Cardiac Catheterization and Angiocardiography%小儿骶管麻醉用于心导管和心血管造影术

    Institute of Scientific and Technical Information of China (English)

    袁惠芬; 郝复; 徐金龙; 陈文英; 汤卫平; 康健; 肖菡


    本文报告骶管麻醉在小儿先天性心脏病心导管和心血管造影术中的应用.骶管麻醉组44例,静脉麻醉12例.结果,骶管麻醉组并发症明显低于单纯静脉麻醉.骶管麻醉不仅有助于导管操作和造影时体位固定,且有利于代谢和血流动力的稳定.%This paper reports the use of caudal anaesthesia in cardiac catheterization and angiocardiaography on children with congenital heart diseases,and the comparison between it and the intravenous anaesthesia on the basis of their angiocardiographic data.In the group of caudal anaesthesia(44 cases),1-1.75% procaine and 0.1-0.15% dicaine solution with adrenaline(1ml /Kg body weight)were given.Intermittent increments of Valium or Ketamine was administered when necessary.Intravenous anaesthesia was applied to 12 cases(Group Ⅱ)with Ketamine and α-hydroxybutyrat or Valium.Results:43.18% of the patients in Group Ⅰ did not require increments of intravenous anaesthetics,but 13 cases Ketamine was given(dosage:0.85-0.49 mg/kg/hr).Ketamine was administered unexceptionally in GroupⅡ with a dosage of 1.61-0.84 mg/kg/hr.There was significant difference between the two groups in the dosage of Ketamie(p<0.02).The caudal anaesthsia group had a much lower occurrence of complications as compared with those who received intravenous anaesthesia alone.The authors considered that caudal anaesthesia is better than intravenous anaethsia in angiocardiography in pediatric cases,for it keeps the pateint well immobulized and makes catheter manipulation easier,and also provides a stable metabolic and haemodynamic condition.

  19. Quantitation of left ventricular regurgitant fraction by first pass radionuclide angiocardiography

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    Janowitz, W.R.; Fester, A.


    A new technique for quantitating left ventricular regurgitant fraction from first pass radionuclide angiocardiographic studies is described. The technique involves measurement of the total number of counts ejected from the right and left ventricles (CR and CL, respectively). In the absence of any valve insufficiency and equal counting efficiency from each ventricle, CR/CL . 1. In the presence of mitral or aortic insufficiency, or both, the regurgitant fraction can be calculated as (CL -- CR)/CL, if no right ventricular regurgitation is present. In this report the theoretical derivation of the method and practical aspects of measuring CL and CR are presented. The technique was tried in a small group of 5 normal volunteers, 7 patients studied with cardiac catheterization without regurgitation and 22 patients with mitral or aortic insufficiency, or both. Excellent correlation was found with cardiac catheterization data in the latter group (r . 0.86, n . 22). This method appears to be a simple and accurate technique for measuring left ventricular regurgitant fraction due to mitral or aortic valve disease, or both.

  20. Assessment of Left Ventricular Volume and Function Using Real-Time 3D Echocardiography versus Angiocardiography in Children with Tetralogy of Fallot


    Abdel Aziz, Faten M; Abdel Dayem, Soha M; Ismail, Reem I; Hassan, Hebah; Aya M Fattouh


    Background Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. Methods Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) refe...

  1. 单发右位心的心血管造影与外科术后诊断对比研究%Comparative studies on diagnosis between angiocardiography and surgery in isolated dextrocardia

    Institute of Scientific and Technical Information of China (English)

    马宁; 蒋世良; 黄连军; 赵世华; 徐仲英; 凌坚; 郑宏



  2. Angiographic studies of atrioventricular discordance. (United States)

    Attie, F; Soni, J; Ovseyevitz, J; Muñoz-Castellanos, L; Testelli, M R; Buendia, A


    The results and value of conventional and axial angiocardiography were studied in 26 cases of atrioventricular discordance (AVD). The angiographic anatomy of this malformation was analyzed to determine the precise characteristics of atrioventricular and ventriculoarterial connections. The left and right ventricles in atrial situs solitus and levocardia show angiographic features that differ from those seen in atrial situs solitus and dextrocardia. The same differences are found in atrial situs inversus. Regardless of the type of ventriculoarterial connections, the ventricles maintain the same angiographic characteristics. The ventricular septum in AVD in situs solitus and levocardia and situs inversus and dextrocardia has a peculiar orientation. The use of axial angiocardiography facilitates detection and localization of the ventricular septal defect. In cases of malposition of the heart, the conventional frontal view allows visualization of the ventricular septum in all of its length. The axial projection is useful in diagnosing left ventricular outflow tract obstruction.

  3. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)


    920654 Angiocardiography in double out-let right ventricle with emphasis on anato-mic types, diagnosis and differential dia-gnosis. LI Yiqun (李益群), et al. Dept Radiol,Cardiovasc Instit & Fuwai Hosp, CAMS, 100037.Chin J Radiol 1992; 26(6): 380-384. Based on the correlative study of angiocardic-graphy and surgical exploration in 52 cases with

  4. Cor triatriatum dextrum - an unusual variant of triatrial heart

    International Nuclear Information System (INIS)

    The present report describes a rare case of triatrial heart, cor triatriatum dextrum in a 31-year-old woman in whom the anomaly was incidentally detected by radionuclide angiocardiography. Subsequent assessment with two-dimensional echocardiography and right heart catheterization confirmed the presence of a membrane subdividing the right atrium into two distinct chambers. To the best of our knowledge, this is the only case in which this cardiac anomaly was demonstrated by radionuclide technique. (orig.)

  5. Cardiac Malpositions

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    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  6. Assessment of ventricular function with first-pass radionuclide angiography using technetium 99m hexakis-2-methoxyisobutylisonitrile: A European multicentre study

    Energy Technology Data Exchange (ETDEWEB)

    Bisi, G.; Sciagra, R. (Florence Univ. (Italy). Dipt. di Fisiopatologia Clinica); Buell, U. (Technische Hochschule Aachen (Germany, F.R.). Medizinische Fakultaet); Britton, K.E. (Saint Bartholomew' s Hospital, London (UK). Dept. of Nuclear Medicine); Eilles, C. (Luitpoldkrankenhaus, Wuerzburg (Germany, F.R.)); Eissner, D.; Hahn, K. (Mainz Univ. (Germany, F.R.). Klinikum); Hoeffken, H.; Joseph, K. (Marburg Univ. (Germany, F.R.). Klinikum); McKillop, J.H. (Royal Infirmary, Glasgow (UK). Dept. of Medicine); Larock, M.P.; Rigo, P. (Centre Hospitalier Universitaire Sart-Tilman, Tilman (Belgium). Service de Medecine Nucleaire); Mueller, S.P.; Reiners, C. (Essen Univ. (Gesamthochschule) (Germany, F.R.). Klinikum)


    In the context of a multicentre study on the use of technetium 99m hexakis-2-methoxyisobutylisonitrile ({sup 99m}Tc-Sestamibi), we evaluated the accuracy of the ventricular function assessed at rest by means of first-pass radionuclide angiocardiography acquired during the injection of the tracer for myocardial perfursion scintigraphy. The results were compared with first-pass studies performed using reference tracers sodium pertechnetate Tc 99m or technetium 99m diethylene triamine penta-acetic acid or with gated radionuclide angiocardiography. A total of 66 patients of the 105 enrolled in the study could be evaluated. The comparison of the first-pass studies was possible in 33 subjects with regard to the left ventricular ejection fraction, yielding r=0.909 (P<10{sup -6}), and in 22 cases with regard to the right ventricular ejection fraction, yielding r=0.712 (P<0.001). The comparison between the first-pass study using {sup 99m}Tc-Sestamibi and the equilibrium gated radionuclide angiocardiography was possible for the left ventricular ejection fraction in 26 cases, with r = 0.937 (P<10{sup -6}), and for the right ventricular ejection fraction in 15 subjects, with r=0.783 (P<0.001). In conclusion, the assessment of ventricular function performed by acquiring a first-pass radionuclide angiocardiograph during the injection of {sup 99m}Tc-Sestamibi for perfusion myocardial scintigraphy can be considered reliable and accurate, when compared with the usually employed techniques. This result confirms the feasibility of a combined evaluation of perfusion and function at rest and during stress testing, which represents one of the most interesting advantages offered by the use of {sup 99m}Tc-Sestamibi. (orig.).

  7. Radionuclide assessment of left ventricular function following cardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Howe, W.R.; Jones, R.H.; Sabiston, D.C. Jr.


    Use of a high count-rate gamma scintillation camera permits the noninvasive assessment of left ventricular function by nuclear angiocardiography. Counts recorded from the region of the left ventricle at 50- or 100-msec intervals during the first transit of an intravenously administered bolus of radioisotope produce a high-fidelity indicator-dilution curve. Count fluctuations reflect left ventricular volume changes during the cardiac cycle and permit measurement of dv/dt, ejection fraction, mean transit time, and wall motion of this chamber. The present study evaluates (1) the accuracy of this technique compared to standard biplane cineangiography and (2) its usefulness in evaluating patients after cardiac surgery.

  8. Scimitar syndrome with horseshoe lung

    Energy Technology Data Exchange (ETDEWEB)

    Beitzke, A.; Gypser, G.; Sager, W.D.


    A combination of two rare malformations of the lung was observed in a four-year-old asymptomatic boy. He had typical scimitar syndrome (dextrocardia, hypoplastic right lung and right-sided anomalous pulmonary venous drainage into the v. cava inferior) together with horseshoe lung. Diagnosis was established by angiocardiography and computerized tomography. In the absence of recurrent pulmonary infections operative intervention is not necessary with normal pulmonary arterial pressure and resistance. To the best of our knowledge this case with both malformations seems to be the fourth which is reported in the literature.

  9. Value and limits of the computed tomography of the heart

    International Nuclear Information System (INIS)

    In cardiac diagnosis we can observe an increasing replacement of the conventional invasive examination methods by less invasive or non invasive procedures. Non invasive examination methods are sufficient in the diagnostic work-up of ventricular function in coronary heart disease and cardiomyopathie, cardiac tumours and thrombi, calcifications, assessment of the bypass perfusion, pericardial disease, positional anomalies of the heart and the morphological changes caused by congenital cardiovascular defects. Invasive angiocardiography remains essential in the diagnosis of coronary artery stenoses, abnormal bypass perfusion, septal defects and in congenital cardiovascular defects in combination with intracardiac measurements of pressure and oxygenation. (orig.)

  10. Assessment of regional left ventricular function by Dual Source Computed Tomography: Interobserver variability and validation to laevocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Pflederer, T. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Ho, K.T. [Department of Cardiology, Tan Tock Seng Hospital (Singapore)], E-mail:; Anger, T. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Kraehner, R. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Ropers, D. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Muschiol, G. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Renz, A. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Daniel, W.G. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:; Achenbach, S. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail:


    Objective: Assessment of left ventricular function is possible in contrast-enhanced cardiac CT data sets. However, rapid ventricular motion especially in systole can lead to artifacts. Dual Source Computed Tomography (DSCT) has high temporal resolution which effectively limits motion artifact. We therefore assessed the accuracy of DSCT to detect regional left ventricular wall motion abnormalities in comparison to invasive cine angiocardiography. Methods: We analyzed DSCT data sets of 50 patients (39 male, 11 female, mean age: 61 {+-} 10 years) which were acquired after intravenous injection of 55-70 mL contrast agent (rotation time: 330 ms, collimation: 2 mm x 64 mm x 0.6 mm, 120 kV, 380 mAs, ECG-correlated tube current modulation). 10 data sets consisting of transaxial slices with a slice thickness of 1.5 mm, an increment of 1.0 mm and a matrix of 256 x 256 pixels were reconstructed at 10 time instants during the cardiac cycle (0-90% in 10% increments). The data sets were analyzed visually by two independent readers, using standard left ventricular planes, concerning regional wall motion abnormalities. DSCT was verified in a blinded fashion against cine ventriculography performed during cardiac catheterization (RAO and LAO projection), using a 7-segment model. Analysis was performed on a per-patient (presence of at least one hypo-, a- or dyskinetic segment) and on a per-segment basis. Results: Concerning the presence of a wall motion abnormality, the two observers agreed in 340/350 segments (97%) and 48/50 patients (96%). In invasive cine angiocardiography, 22 of 50 patients displayed at least one segment with abnormal contraction. To detect these patients, DSCT showed a sensitivity of 95% (21/22), specificity of 96% (27/28), positive predictive value of 95% and negative predictive value of 96%. Out of a total of 350 left ventricular segments, 66 segments had abnormal contraction in cine angiocardiography (34 hypokinetic, 26 akinetic, 6 dyskinetic). For detection

  11. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    Energy Technology Data Exchange (ETDEWEB)

    Kiseleva, I.P.; Podzolkov, V.P.; Ivanitskij, A.V.; Mal' sagov, G.U. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Serdechno-Sosudistoj Khirurgii; Tsentral' nyj Inst. Usovershenstvovaniya Vrachej, Moscow (USSR))

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography.

  12. Positron Emission Tomography of the Heart (United States)

    Schelbert, H. R.; Phelps, M. E.; Kuhl, D. E.


    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease.

  13. Small aortic valve annulus in children with fixed subaortic stenosis. (United States)

    Thilenius, O G; Campbell, D; Bharati, S; Lev, M; Arcilla, R A


    Twenty-one hearts with fixed subaortic stenosis (FSAS) were examined pathologically. Thirty children with no hemodynamically significant heart disease, 31 children with valvar aortic stenosis, and 25 children with FSAS were studied by echo- and angiocardiography. The following conclusions were drawn: (1) Patients with FSAS often have abnormal aortic valve leaflets as well as small aortic valve annulus. (2) A small aortic annulus/descending aorta ratio is probably present at birth, and may decrease with increasing age. (3) In some patients with FSAS the aortic valve annulus is too small for simple resection of the fibroelastic tissue. A Konno operation is needed for these patients. (4) M-mode echocardiography has not been useful in identifying abnormally small aortic valve annulus in FSAS patients.

  14. Role of nuclear medicine in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, Kohei; Nishimura, Tsunehiko; Uehara, Toshiisa; Naito, Hiroaki; Omine, Hiromi; Kozuka, Takahiro (National Cardiovascular Center, Suita, Osaka (Japan))


    With the progress in gamma camera and computer system, nuclear medicine has been applied for diagnostic tool in ischemic heart disease. There are two devices for cardiac images; (1) Radionuclide angiocardiography (RNA) by in vivo sup(99m)Tc-RBC labeling (2) Myocardial imaging by /sup 201/Tlcl. RNA can evaluate the kinesis of wall motion of left ventricle with gated pool scan and also detect reserve of cardiac function with exercise study. Myocardial imaging at rest can identify myocardial necrosis and the imaging in exercise can detect myocardial ischemia. The elaborateness and reproducibility of cardiac image in nuclear medicine will play the great role to evaluate clinical stage of ischemic heart disease by not only imaging but also functional diagnosis.

  15. Comparison between scintiscanning and pulmonary angiography in the diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    In the diagnosis of pulmonary embolism, radio-isotope scanning is specific when it reveals complete absence of focal, lobar or segmental perfusion. Diffuse reductions in perfusion cannot be considered significant except in patients with healthy heart and lungs. Radio-isotope scanning shows up well peripheral emboli. Angiography provides definite evidence when it shows up intravascular lacunae or definite vascular obstructions, the diagnosis is probable when localised hypovascularisation or asymmetric vascularisation are found. Angiocardiography and pulmonary scintiscanning are neither contrary nor comparable. Radio-isotope scanning is simpler and less dangerous perhaps and may always be carried out. When it is normal, it eliminates definitely the necessity for angiography the results of which are still morphological

  16. Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation

    DEFF Research Database (Denmark)

    Stokholm, K H; Breum, L; Astrup, A


    pressure (BP) declined. The fall in BP was caused by the reduction in cardiac output as the total peripheral resistance was unchanged. Finally, the decline in total blood volume was not significant. These findings together with a reduction in heart rate indicated that a reduced sympathetic tone via......Eight obese patients were studied before and after 2 weeks of treatment by a very-low-calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I-albumin) and radionuclide angiocardiography (first pass...... and equilibrium technique by [99Tcm]red blood cells). Cardiac output decreased concomitantly with the reduction in oxygen uptake as the calculated systemic arteriovenous difference of oxygen was unaltered. There were no significant decreases in left ventricular contractility indices, i.e. the ejection fraction...

  17. Positron emission tomography of the heart

    International Nuclear Information System (INIS)

    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease

  18. Noninvasive measurement of pulmonary blood volume

    International Nuclear Information System (INIS)

    In noninvasive estimation of pulmonary blood volume by radionuclide-angiocardiography, a formula was derived from experiments with heart-lung model, and in vivo experiments PBV = CO x PPT x 0.77. The pulmonary blood volume estimated clinically by this formula was in good agreement with the results obtained invasively before. The compliance (δV/δP) of the pulmonary ''venous'' system was calculated by simultaneous measurement of pressure changes in lung field on leg elevation and changes in pulmonary arterial wedge pressure with Swan-Ganz catheter. The compliances which were calculated in 35 cases of heart diseases by this method were in a considerably good agreement with those which were assessed by analysis of a pulmonary arterial wedge pressure tracing. (Ueda, J.)

  19. Reliability of myocardial perfusion quantification in angiography using a digital flat panel cardiac system (United States)

    Perrin, Muriel; Vaillant, Regis; Gavit-Houdant, Laurence; Lienard, Jean; Benali, Karim


    Discordance between lesion severity from angiocardiography and physiological effects has been reported elsewhere. Quantification of myocardial perfusion during the angiography procedure may supply additional information about short- and long-term outcomes and may be helpful for clinical decision making. In previous works, myocardial perfusion has been assessed using time density curves (TDC), which represent the contrast medium dilution over time in the myocardium. The mean transit time (MTT), derived from the TDC, has been reported as a good indicator of the regional myocardial perfusion. Our objective is to estimate the accuracy and reproducibility of MTT estimation on digital flat panel (DFP) images. We have simulated typical myocardium TDC obtained with a DFP cardiac system (Innova 2000, GE), taking into account scatter and noise. Logarithmic or linear subtractions have been applied to derive a contrast medium concentration proportional quantity from image intensity. A non-linear minimisation realises the model curve fitting. MTT estimates are more stable with linear subtraction in presence of scatter. However logarithmic subtraction presents smaller bias when scatter level is small. Both approaches are equally sensible to image noise. Linear subtraction should be preferred. Image noise has a high influence on MTT accuracy and we may reduce.

  20. Physiologic response of canine hearts to change in size of dose per fraction

    International Nuclear Information System (INIS)

    Eighty dogs were assigned randomly to three groups which received variable total doses given in either 2,3 or 4 Gy fractions. All doses were delivered in a four-week period. There were three or four dogs at each dose level. Hearts were irradiated with 5 MV x rays given through parallel opposed lateral portals. Echocardiography was used to determine the presence of pericardial effusion, cardiac contractility and wall thickness. Angiocardiography was used to determine stroke volumes and ejection fractions. Dose response curves were plotted for each of the three different size of dose per fraction groups. Isoeffective doses were determined from the dose response plots. Six months after irradiation, the dose with a 50% probability for causing measurable pericardial effusion decreased from 67.3 Gy to 49.5 Gy when the size of dose per fraction was increased from 2 Gy to 4 Gy. Other isoeffects were affected to a similar degree. Alpha/beta ratios calculated from isoeffect plots were about 3 Gy for most parameters

  1. Clinical cardiovascular experiences with iopamidol: a new non-ionic contrast medium. (United States)

    Partridge, J B; Robinson, P J; Turnbull, C M; Stoker, J B; Boyle, R M; Morrison, G W


    Iopamidol, a new non-ionic water-soluble contrast medium, has been compared with standard ionic media in a number of cardiovascular applications. It is stable in aqueous solution, is much less viscous and only slightly more osmolar than metrizamide. Compared to sodium meglumine diatrizoate in a series of 40 coronary arteriograms, it produced a consistent and highly significant decrease in the incidence and severity of hypotension and bradycardia following intracoronary injection. In the same group and in 62 children undergoing ventricular or great vessel angiocardiography, a subjective assessment of patient reaction showed that iopamidol was better tolerated than the ionic medium. There was a very strong patient preference for iopamidol in a group of 20 of the adult patients who had also consented to femoral artery injections of both media. Throughout these series there was no detectable difference in arterial image quality between the media. Venous phase opacification during arterioportography was assessed in 11 cases comparing iopamidol with sodium meglumine iothalamate. No significant difference was found. We conclude that iopamidol is clearly preferable to ionic media for routine cardiovascular applications.

  2. Radiation doses and correlated late effects in diagnostic radiology

    International Nuclear Information System (INIS)

    Patient irradiation in diagnostic radiology was estimated from measurements of absorbed doses in different organs, assessment of the energy imparted and retrospective calculations based on literature data. Possible late biological effects, with special aspects on children, were surveyed. The dose to the lens of the eye and the possibility of shielding in carotid angiography was studied as was the absorbed dose to the thyroid gland at cardiac catheterization and angiocardiography in children. Calculations of the mean bone marrow dose and gonad doses were performed in children with chronic skeletal disease revealing large contributions from examinations of organs other than the skeleton. The dose distribution in the breast in mammography was investigated. Comparison of the energy imparted in common roentgen examinations in 1960 and 1975 showed an unexpected low decrease in spite of technical improvements. Reasons for the failing decrease are discussed. The energy imparted to children in urological examinations was reduced significantly due to introduction of high sensitivity screens and omission of dose demanding projections. Contributions to the possible late effects were estimated on the basis of the organ doses assessed. (author)

  3. Accuracy of diagnosis of coronary artery disease by radionuclide management of left ventricular function during rest and exercise

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R.H.; McEwan, P.; Newman, G.E.; Port, S.; Rerych, S.K.; Scholz, P.M.; Upton, M.T.; Peter, C.A.; Austin, E.H.; Leong, K.H.; Gibbons, R.J.; Cobb, F.R.; Coleman, R.E.; Sabiston, D.C. Jr.


    Rest and exercise radionuclide angiocardiographic measurements of left ventricular function were obtained in 496 patients who underwent cardiac catheterization for chest pain. Two hundred forty-eight of these patients also had an exercise treadmill test. An ejection fraction less than 50% was the abnormality of resting left ventricular function that provided the greatest diagnostic information. In patients with normal resting left ventricular function, exercise abnormalities that were optimal for diagnosis of coronary artery disease were an injection fraction at least 6% less than predicted, an increase greater than 20 ml in end-systolic volume and the appearance of an exercise-induced wall motion abnormality. The sensitivity and specificity of the test were lower in patients who were taking propranolol at the time of study and in patients who failed to achieve an adequate exercise end point. In the 387 patients with an optimal study, the test had a sensitivity of 90% and a specificity of 58%. Radionuclide angiocardiography was more sensitive and less specific than the exercise treadmill test. The high degree of sensitivity of the radionuclide test suggests that it is most appropriately applied to patient groups with a high prevalence of disease, including those considered for cardiac catheterization.

  4. Corrected transposition of the great arteries

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Hi; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consists of transposition of great arteries and ventricular inversion, and which is caused by abnormal development of conotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to get accurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between September 1976 and June 1981. The clinical, radiographic, and operative findings with the emphasis on the angiocardiographic findings were analyzed. The results are as follows: 1. Among 18 cases, 13 cases have normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situs inversus and 1 case has levocardia with situs inversus. 2. Segmental sets are (S, L, L) in 15 cases, and (I, D,D) in 3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and both semilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5. Associated cardic malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in 2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively. 6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is an essential procedure.

  5. Radionuclide assessment of left ventricular diastolic function in patients with mitral stenosis before and after percutaneous transvenous mitral commissurotomy; Use of list mode method in patients with atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Seishi; Iwasaka, Toshiji; Kimura, Yutaka; Ohkubo, Naohiko; Matsuura, Takashi; Inada, Mitsuo; Shiraishi, Tomokuni (Kansai Medical School, Moriguchi, Osaka (Japan))


    To evaluate the effect of percutaneous transvenous mitral commissurotomy (PTMC), equilibrium radionuclide angiocardiography was performed in eight patients with mitral stenosis who had atrial fibrillation. Accurate cardiac function in patients with atrial fibrillation is difficult to assess, since the wide fluctation of cardiac cycle makes the ventricular hemodynamics variable. A new processing algorhythm was devised to make multiple gated images discriminated from a heart rate distribution histogram. We obtained about 1,000 beats data by list mode acquisition, and processed a heart rate distribution histogram. The data in the area {+-}5% of the most frequent heart rate were converted into frame mode and a representative time activity curve was derived. Mitral valve area calculated by echocardiography increased from 1.3{+-}0.5 to 2.0{+-}0.6 (cm{sup 2}) significantly (p<0.01). The mean transmitral pressure gradient measured by catheterization decreased from 12.4{+-}5.9 to 4.9{+-}3.7 (mmHg) significantly (p<0.01) and the clinical symptoms improved in all patients. The change in left ventricular ejection fraction from 43{+-}9 to 48{+-}13 (%) was not statistically significant, but peak filling rate (PFR) derived from the time activity curve increased from 1.5{+-}0.3 to 2.0{+-}0.4 (EDV/sec) significantly (p<0.01). Thus PFR is a noninvasive parameter that can evaluate the effect of PTMC. (author).

  6. Alteration of Peripheral Blood T-Reg Cells and Cytokines Production in Angiography Personnel Exposed to Scattered X-Rays

    Directory of Open Access Journals (Sweden)

    Ebrahim Torkabadi


    Full Text Available Angiocardiography is an X-ray examination of the blood vessels or chambers of the heart. Cardiologists and staff members applying this procedure are exposed to high levels of scattered radiation. In our previous study the incidence of unstable chromosomal aberrations and cytokinesis-blocked micronuclei were found to be significantly higher in exposed individuals than the age and sex matched controls. In the present study we assessed cytokine production by peripheral blood mononuclear cells of the above cases and the percentage of Treg cells. According to film dosimeter analysis, personnels received 0.25-15 mSv during the previous year (average of 3 mSv/y. Isolated PBMCs from the test and control groups were stimulated with Phorbol Myristate Acetate/ Ionomycin (PMA/I. Cytokine production was measured in the supernatants of cultured lymphocytes. The percentage of Treg cells was studied by flow cytometry. The production of IL-10 and IL-5 was significantly down-regulated in the test group compared to the control group. In contrast, IL-12 was up-regulated. Yet, no statistically significant difference was found for IFN- γ between two groups. In addition, we found higher percentage of CD4+CD25+bright Treg cells in the study group compared to the controls. Taken together, it was shown that low doses of scattered X-rays could skew cytokine profile of peripheral blood mononuclear cells in favour of inflammatory response causing the increase of Treg cells.

  7. Magnetic resonance imaging of congenital cardiac abnormalities

    International Nuclear Information System (INIS)

    Magnetic resonance imaging will not replace echocardiography as the simplest and most definitive method of establishing a noninvasive diagnosis in young patients with congenital cardiac malformations, nor will it replace radionuclide angiography for relatively noninvasive detection and quantitation of cardiac shunts. Magnetic resonance imaging is a complementary noninvasive imaging procedure that can answer some questions left in doubt by echocardiography (mainly extracardiac artery and vein assessments) or radionuclide angiography and used as a preferred follow-up imaging method in certain clinical circumstances. In addition, MRI can be a first-line modality for cardiovascular imaging in older patients in whom adequate echo windows are not available. Angiocardiography remains necessary to provide vital physiological data, i.e., chamber pressures, shunt volumes, oxygen saturations, and pulmonary vascular resistance; however, MRI could negate some follow-up catheterizations in appropriate clinical circumstances. High-resolution proton MRI tomography should ultimately permit the accurate evaluation of ventricular volumes, myocardial mass, and the assessment of regional wall motion and ejection fractions. Paramagnetic substances such as manganese ion may ultimately provide a basis for myocardial perfusion imaging. The potential for MRI evaluation of tissue characterization, noninvasive blood-flow measurements, and myocardial metabolism assessment in intriguing and awaits clinical evaluation

  8. Left ventricular diastolic filling improvement obtained by intravenous verapamil in mild to moderate essential hypertension: a complex effect. (United States)

    Franchi, F; Fabbri, G; Monopoli, A; Rossi, D; Matassi, L; Strazzulla, G; Bisi, G


    In order to try and evaluate through what prevailing mechanism verapamil (V) can induce an improvement in left ventricular (LV) diastolic early filling in mild to moderate essential hypertension, 43 properly classified essential hypertensives, aged 41-74 years (mean age 58.1 +/- 10.3), and 20 age-matched normotensives were studied. All subjects underwent both echocardiographic evaluation and 99mTc radionuclide angiocardiography in basal conditions between 8.00 a.m. and noon, after an overnight rest. In essential hypertensives gated equilibrium angiocardiography was repeated 3 and 30 min after i.v. V (0.1-mg/kg bolus, followed by 0.005 mg/kg/min for the period of radionuclide data acquisition). Simultaneously, supine arterial pressure was measured with a cuff manometer. In 36 essential hypertensives a phono-echo evaluation was obtained, both at 3 and 30 min after V, deriving a LV isovolumetric relaxation index (IRTI). Among diastolic early filling indices, we particularly considered the ratio of peak filling rate (PFR) to peak ejection rate (PER) in order to take into account the interaction of systolic performance with LV relaxation and diastolic early filling. Three minutes after V the increase in PFR (from 2.47 +/- 0.5 to 3.04 +/- 0.8 EDV/s, p less than 0.001) and the upwards tendency of PFR/PER were coupled with the enhancement in ejection fraction (from 61.1 +/- 13.3 to 63.9 +/- 13.8%, p less than 0.001) and heart rate (from 70.3 +/- 12.6 to 77.7 +/- 12.2 b/min, p less than 0.001) and with the reduction in mean arterial pressure (from 122 +/- 16 to 107 +/- 14 mm Hg, p less than 0.001), systemic arterial resistance index (from 3,234 +/- 968 to 2,432 +/- 678 dyn s cm-5 m2, p less than 0.001) and end-systolic volume index (from 32.9 +/- 17.1 to 31.5 +/- 18.3 ml/m2, p less than 0.02). On the contrary, 30 min after V, when systolic indices, heart rate, mean arterial pressure and systemic arterial resistance index had returned towards baseline values, PFR/PER showed

  9. Angiography of double outlet of right ventricles%右心室双出口的心血管造影诊断

    Institute of Scientific and Technical Information of China (English)

    申玉良; 侯爱军; 武艳强; 袁芳


    目的 评价心血管造影对右心室双出口的诊断价值.方法 收集11例右心室双出口患者的临床及心血管造影资料并进行回顾性分析.全部患者均行X线、心电图、超声心动图心导管及心血管造影检查.结果 所有患者的心血管造影诊断与术后诊断完全相符,符合率为100%.11例主动脉、肺动脉同时显影,两大动脉起自右心室.8例室间隔缺损,3例心内膜垫缺损.其中5例室间隔缺损位于肺动脉瓣下,同时并右冠状动脉异位开口;3例室间隔缺损位于主动脉、肺动脉之间,同时合并左右心房互换、永存左上腔静脉;2例室间隔缺损远离肺动脉和主动脉,肺动脉发育差.另1例心内膜垫缺损合并二尖瓣、三尖瓣重度关闭不全.结论 心血管造影对右心室双出口及合并畸形可做出较准确诊断.%Objective To report 11 cases of double outlet of right ventricles and to evaluate the methods of angiography.Methods Angiocardiographies of 11 patients were collected.All patients underwent X-ray film,electro-cardiography,echocardiography,cardiac catheterization and angiocardiography.Results The coincidence rate between angiography and operation was 100%.Angiographies were performed in 11 patients.Both great arteries(Aorta and Pulmonary Artery) originated from the right ventricle in all the cases.8 patients had ventricular septal defect(VSD) and 3 patients had endocardial cushion defect.Five cases of the VSDs were found under the valve of pulmonary artery and were accompanied with anomalous origin of the right coronary artery;3 cases of the VSDs were found to be between the aorta and pulmonary artery and were accompanied with position interchange of two atria and persistent left superior vena cava;2 eases of the VSDs were found being away from aorta and pulmonary artery as well as agenesis of pulmonary artery.The last case of the endocrinal cushion defect were accompanied with mitral valve insufficiency and severe

  10. Congenital abnormalities of the aorta in children and adolescents; Angeborene Fehlbildungen der Aorta im Kindes- und Jugendalter

    Energy Technology Data Exchange (ETDEWEB)

    Eichhorn, J.G. [Universitaetskinderklinik Heidelberg, Abt. Paediatrische Kardiologie, Heidelberg (Germany); Ley, S. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abt. Radiologie, Heidelberg (Germany); Radiologische Universitaetsklinik Heidelberg, Abt. Paediatrische Radiologie, Heidelberg (Germany)


    Aortic abnormalities are common cardiovascular malformations accounting for 15-20% of all congenital heart disease. Ultrafast CT and MR imaging are noninvasive, accurate and robust techniques that can be used in the diagnosis of aortic malformations. While their sensitivity in detecting vascular abnormalities seems to be as good as that of conventional catheter angiocardiography, at over 90%, they are superior in the diagnosis of potentially life-threatening complications, such as tracheal, bronchial, or esophageal compression. It has been shown that more than 80% of small children with aortic abnormalities benefit directly from the use of noninvasive imaging: either cardiac catheterization is no longer necessary or radiation doses and periods of general anesthesia for interventional catheterization procedures can be much reduced. The most important congenital abnormalities of the aorta in children and adolescents are presented with reference to examples, and the value of CT and MR angiography is documented. (orig.) [German] Fehlbildungen der Aorta gehoeren zu den haeufigen kongenitalen kardiovaskulaeren Malformationen (15-20% aller angeborenen Herzfehler). Die raeumlich und zeitlich hochaufloesenden Methoden der Computer- (CT-) und Magnetresonanztomographie (MRT) sind nichtinvasive, hochwertige und aussagekraeftige Methoden zur Diagnostik angeborener Fehlbildungen der Aorta. Sie zeigen sich in der Diagnostik der Gefaessanomalien gleichwertig zur konventionellen Angiographie mit Sensitivitaeten von mehr als 90%. In der Diagnostik assoziierter Komplikationen, wie trachealen, bronchialen oder oesophagialen Kompressionen, sind sie ueberlegen. Es konnte gezeigt werden, dass 80% der Kleinkinder mit Fehlbildungen der Aorta einen direkten Vorteil von der nichtinvasiven Bildgebung hatten: Entweder war eine Herzkatheterung fuer die Therapieplanung nicht mehr erforderlich oder die Durchleuchtungs- und Narkosezeiten bei der Katheterintervention konnten deutlich verkuerzt

  11. The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Andrey A. Ivanov


    Full Text Available The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS in 38 (33.3% patients, aortic valve insufficiency (AVI in 33 (28.9%, and combined heart defects in 56 patients (49.1%.Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%, whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA.Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

  12. Comparison of nifedipine gastrointestinal therapeutic system and atenolol on antianginal efficacies and exercise hemodynamic responses in stable angina pectoris. (United States)

    Wallace, W A; Wellington, K L; Chess, M A; Liang, C S


    A gastrointestinal therapeutic system (GITS) of nifedipine has been developed to provide a once-daily dosing, and predictable, relatively constant plasma concentrations. This study compared the antianginal efficacy of nifedipine GITS with a once-a-day beta-receptor blocker, atenolol. Seventeen patients with documented coronary artery disease and stable stress-induced angina pectoris were studied during a 2-week, single-blind, placebo baseline phase and a 12-week randomized, double-blind, active drug crossover efficacy phase, using the bicycle exercise test and ambulatory electrocardiographic recordings. Patients exercised significantly longer with nifedipine GITS (883 +/- 47 seconds) and atenolol (908 +/- 44 seconds) than with placebo (794 +/- 41 seconds). Nifedipine GITS reduced systolic blood pressure at all stages of exercise compared with placebo but, because heart rate tended to increase more during nifedipine therapy, there was no difference in rate-pressure products between the placebo and nifedipine GITS periods. In contrast, atenolol reduced heart rate, systolic blood pressure and rate-pressure product during exercise compared with placebo. Whereas left ventricular ejection fractions (by radionuclide angiocardiography) increased with exercise, the maximal increase was smaller with atenolol than with placebo and nifedipine. The net increase in left ventricular ejection fraction at the end of exercise was greater with nifedipine than with placebo or atenolol. Ambulatory electrocardiograms showed only a small number of ischemic events. Neither nifedipine GITS nor atenolol reduced the number of ischemic events or total duration of ST-segment deviations significantly. It is concluded that nifedipine GITS is as effective an antianginal agent as atenolol, but the hemodynamic effects of the 2 agents differ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8279372


    Institute of Scientific and Technical Information of China (English)


    Purpose.To introduce the epidemical, pathological, and clinical characteristics as well as the diagnostic and therapeutical experiences of endomyocardial fibrosis(EMF) in China. Data sources.A CMBdisc search was done of the Chinese-language literature published from January 1983 through June 1997 about EMF and/or restrictive cardiomyopathy. A manual search was then done for other contributions, including abstracts, between January 1965 and June 1997.Results. Eighty-seven Chinese cases of EMF were collected in this paper. There were 49 men and 38 women, with a mean age of 28±13 years(range, 8 to 68 years). The distribution of the cases is mainly in the south of China. Combined right and left ventricular disease occurs in 48 percent of cases, with pure right ventricular involvement occurring in 42 percent and pure left ventricular involvement in the remaining 10 percent of patients who are examined postmortem. The diagnosis of EMF was confirmed in 21 cases at autopsy, and in 66 cases by echocardiography, angiocardiography, and/or endomyocardial biopsy which showed the characteristic changes. Clinically, right-sided disease is the commonest variety. Endocardiectomy and tricuspid(n=7) or mitral(n=1) valves replacement have been performed in 8 patients. There were 2 operative deaths. Six patients had a satisfactory recovery postoperatively and living well in the follow-up duration. Conclusion.EMF has been diagnosed clinically and confirmed at necropsy in a number of cases in the south of China. The etiology, incidence and epidemiology are still unknown. The pathological and clinical features are similar to those in tropical areas, but right ventricular involvement is the commonest type in our country.

  14. [Determination of the ejection fraction of the left ventricle by videodensitometric analysis of digital angiography. Preliminary results]. (United States)

    Angel, C Y; Vuthien, H; Letienne, G; Pernes, J M; Brenot, P; Parola, J L; Raynaud, A; Gaux, J C


    Digitalisation enables angiocardiography to be performed by a peripheral intravenous injection. Computer-assisted analysis of the date widens the possibilities of quantification. The authors have developed a videodensitometric method of studying the left ventricular ejection fraction. The research was performed on an experimental model and the technique validated in a series of 10 patients. The experimental model consisted of a series of balloons which, when inflated with contrast medium assumed an allipsoid shape resembling a left ventricle. The balloons were blown up in two stages with an automatic injector to simulate systole and diastole. The images were recorded in the same way as during ventriculography. Videodensitometric measurements showed 3 to 5% variations from the true values. The method was then applied to the calculation of the left ventricular ejection fraction in 10 patients: left ventricular function was also quantified by geometrical methods (Dodge) from the same angiogrammes and the 2 sets of results were then compared. The correlation coefficient between the two methods was 0.97, so validating the new technique. Videodensitometry opens up new perspectives in the study of left ventricular function. On the other hand it can be used to monitor the ejection fraction in severely ill or recently operated patients, and, on the other hand the principle of videodensitometry eliminates the geometrical approximations inherent in the classical methods of angiographic analysis and would therefore seem to be more suitable for the study of pathological left ventricules (aneurysm...). Finally, the technique of videodensitometry represents a new step towards the measurement of true volumes and flow rates. PMID:3935074

  15. Straddling mitral valve with hypoplastic right ventricle, crisscross atrioventricular relations, double outlet right ventricle and dextrocardia: morphologic, diagnostic and surgical considerations. (United States)

    Geva, T; Van Praagh, S; Sanders, S P; Mayer, J E; Van Praagh, R


    The clinical, surgical and morphologic findings in five cases of a rare form of straddling mitral valve are presented. Three patients were diagnosed by two-dimensional echocardiography, cardiac catheterization and angiocardiography and two had diagnostic confirmation at autopsy. All five cases shared a distinctive and consistent combination of anomalies: 1) dextrocardia; 2) visceroatrial situs solitus, concordant ventricular D-loop and double outlet right ventricle with the aorta positioned to the left of and anterior to the pulmonary artery; 3) hypoplasia of right ventricular inflow (sinus) with tricuspid valve stenosis or hypoplasia; 4) large right ventricular infundibulum (outflow); 5) malalignment conoventricular septal defect; 6) straddling mitral valve with chordal attachments to the left ventricle and right ventricular infundibulum; 7) severe subpulmonary stenosis with well developed pulmonary arteries; and 8) superoinferior ventricles with crisscross atrioventricular (AV) relations. The degree of malalignment between the atrial and ventricular septa was studied quantitatively by measuring the AV septal angle projected on the frontal plane. The AV septal angle in the two postmortem cases was 150 degrees, reflecting marked malalignment of the ventricles relative to the atria. This AV malalignment appears to play an important role in the morphogenesis of straddling mitral valve. As judged by a companion study of seven postmortem cases, the more common form of straddling mitral valve with a hypertrophied and enlarged right ventricular sinus had less severe ventricular malposition than did the five rare study cases with hypoplastic right ventricular sinus. A competent mitral valve, low pulmonary vascular resistance and low left ventricular end-diastolic pressure were found at cardiac catheterization in the three living patients who underwent a modified Fontan procedure and are doing well 2.2 to 5.8 years postoperatively.

  16. Routine preoperative cardiac catheterization necessary before repair of secundum and sinus venosus atrial septal defects

    International Nuclear Information System (INIS)

    Between January 1976 and July 1983, 217 patients with atrial septal defect underwent surgical repair at Children's Hospital. Thirty with a primum atrial septal defect and 26 who underwent cardiac catheterization elsewhere before being seen were excluded from analysis. Of the 161 remaining patients, 52 (31%) underwent preoperative cardiac catheterization, 38 because the physical examination was considered atypical for a secundum atrial septal defect and 14 because of a preexisting routine indication. One hundred nine (69%) underwent surgery without catheterization, with the attending cardiologist relying on clinical examination alone in 5, additional technetium radionuclide angiocardiography in 5, M-mode echocardiography in 13 and two-dimensional echocardiography in 43; both M-mode echocardiography and radionuclide angiography were performed in 24 and two-dimensional echocardiography and radionuclide angiography in 19. Since 1976, there has been a trend toward a reduction in the use of catheterization and use of one rather than two noninvasive or semiinvasive techniques for the detection of atrial defects. Of the 52 patients who underwent catheterization, the correct anatomic diagnosis was made before catheterization in 47 (90%). Two patients with a sinus venosus defect and one each with a sinus venosus defect plus partial anomalous pulmonary venous connection, partial anomalous pulmonary venous connection without an atrial septal defect and a sinoseptal defect were missed. Of 109 patients without catheterization, a correct morphologic diagnosis was made before surgery in 92 (84%). Nine patients with a sinus venosus defect, three with sinus venous defect and partial anomolous pulmonary venous connection, four with partial anomalous pulmonary venous return without an atrial septal defect and one with a secundum defect were incorrectly diagnosed.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Development of pediatric cardiology in latin america: accomplishments and remaining challenges. (United States)

    Capelli, Horacio; Kreutzer, Christian; Kreutzer, Guillermo


    Until the first quarter of the 20th century, most physicians were more than happy to differentiate congenital heart lesions from rheumatic heart disease, which then was rampant. As early as 1932, Dr Rodolfo Kreutzer, from Buenos Aires, Argentina, was already involved in the study of congenital heart defects. He started off assessing children with a stethoscope and with Einthoven electrocardiography equipment. The cardiac unit at the Buenos Aires Children's Hospital was created in 1936. It established the onset of pediatric cardiology in Argentina and fueled its development in South America. Nearly at the same time, Agustin Castellanos from Cuba also became a pioneer in the assessment of congenital heart disease. He described the clinical applications of intravenous angiocardiography in 1937. Meanwhile in Mexico, Dr Ignacio Chavez founded the National Institute of Cardiology in 1944 in Mexico City. It was the first center in the world to be exclusively devoted to cardiology. From this center, Victor Rubio and Hugo Limon performed the first therapeutic cardiac catheterization in 1953. Meanwhile, Professor Euriclydes Zerbini from Sao Paulo, Brazil, built the largest and most important school of cardiac surgeons in South America. In Santiago, Chile, the Calvo Makenna Hospital was the center where Helmut Jaegger operated on the first infant with extracorporeal circulation in Latin America in 1956. The patient was a 1-month-old baby, with complete transposition of the great arteries, who underwent an Albert procedure. Currently, there are many fully equipped centers all over the region, capable of dealing with most lesions and of providing excellent medical, interventional, and surgical treatment. Outcomes have improved substantially over the last 20 years. These achievements have gone beyond our pioneers' dreams. However, many neonates and young infants die prior to surgery because referral centers are overburdened and have long surgical waiting lists. Clearly, we still

  18. Ionic versus nonionic contrast use. (United States)

    Stolberg, H O; McClennan, B L


    It has taken many years of research, development and intense scientific investigation to produce intravascular contrast media. Research on relations between chemical structure, animal toxicity, and water-solubility has produced a number of highly water-soluble, iodinated compounds for use in diagnostic radiology as intravascular contrast agents. The currently used intravascular agents may be classified into four groups according to their chemical structure: 1. Ionic monomers 2. Ionic monoacid dimers 3. Nonionic monomers 4. Nonionic dimers It is the objective of this publication to review the history and development of intravascular contrast media as well as their properties, general effects and clinical use. The four types of contrast media differ significantly in their chemical structure and physico-chemical properties, and these differences determine their osmotoxicity, chemotoxicity, and ion toxicity. We analyze the organ specific toxic effects of intravascular contrast media upon the central nervous system, the cardiovascular system, and the renal system. We also review the secondary effects, clinical manifestations, and the incidence of adverse events associated with different types of contrast. The choice of contrast media has become critical since the introduction of nonionic agents because their toxicological and pharmacological properties differ from those of the ionic agents. The application of basic concepts involved in the use of contrast media in excretory urography, computed tomography, angiography, and angiocardiography is discussed, and the advantages of the use of nonionic contrast agents are outlined. Economic and ethical issues are presented with emphasis upon strategies to reduce the risk associated with the injection of intravascular contrast and to curtail consumption according to rational principles of use. PMID:2049958

  19. Identification and Assessment of Paradoxical Ventricular Wall Motion Using ECG Gated Blood Pool Scan - Comparison of cine Loop , Phase Analysis and Paradox Image -

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    Lee, Jae Tae; Kim, Gwang Weon; Lee, Kyu Bo; Chung, Byung Chun; Whang, Kee Suk; Chae, Sung Chul; Paek, Wee Hyun; Cheon, Jae Eun [Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Lee, Hyong Woo; Chung, Jin Hong [Yeongnam National University College of Medicine, Daegu (Korea, Republic of)


    Sixty-four patients with paradoxical ventricular wall motion noticed both in angiocardiography or 2-dimensional echocardiography were assessed by ECG gated blood pool scan (GBPS). Endless cine loop image, phase and amplitude images and paradox image obtained by visual inspection of each cardiac beat or Fourier transformation of acquired raw data were investigated to determine the incremental value of GBPS with these processing methods for identification of paradoxical ventricular wall motion. The results were as follows:1) Paradoxical wall motions were observed on interventricular septum in 34 cases, left ventricular free wall in 26 and right ventricular wall in 24. Underlying heart diseases were is chemic (23 cases) valvular(9), congenital heart disease (12), cardiomyopathy (5), pericardial effusion(5), post cardiac surgery(3), corpulmonale (2), endocarditis (l) and right ventricular tumor(l). 2) Left ventricular ejection fractions of patients with paradoxical left ventricular wall motion were significantly lower than those with paradoxical septal motion (p <0.005). 3) The sensitivity of each processing methods for detecting paradoxical wall motion was 76.9% by phase analysis, 74.6% by endless cine loop mapping and 68.4% by paradox image manipulation respectively. Paradoxial motions visualized only in phase, paradox or both images were appeared as hypokinesia or akinesia in cine loop image. 4) All events could be identified by at least one of above three processing methods, however only 34 cases (48.4%) showed the paradoxical motions in all of the three images. By these findings, we concluded that simultaneous inspection of all above three processing methods-endless cine loop, phase analysis and paradox image is necessary for accurate identification and assessment of paradoxical ventricular wall motion when performing GBPS.

  20. Cardiomyopathy in a Harris hawk (Parabuteo unicinctus). (United States)

    Brandão, João; Reynolds, Caryn A; Beaufrère, Hugues; Serio, Jacqueline; Blair, Robert V; Gaschen, Lorrie; Johnson, James G; Del Piero, Fabio; Barker, Steven A; Nevarez, Javier G; Tully, Thomas N


    CASE DESCRIPTION An adult sexually intact female Harris hawk (Parabuteo unicinctus) housed at a wildlife hospital was evaluated because of acute collapse during an educational exhibition. CLINICAL FINDINGS Physical examination and hematologic analysis revealed no abnormalities; radiography revealed findings consistent with a previous tibiotarsal fracture. Coelioscopy with histologic examination and fungal culture of lung and air sac samples revealed anthracosis but no fungal infection. The hawk was discharged and temporarily removed from the education program; 1 month later, upon reintroduction into the program, it collapsed again. Physical examination and hematologic findings were similar to those after the first episode. Transcoelomic and transesophageal echocardiography and CT angiocardiography findings were consistent with cardiomyopathy. TREATMENT AND OUTCOME Initial cardiac treatment included furosemide (0.5 mg/kg [0.23 mg/lb], PO, q 24 h) and pimobendan (10 mg/kg [4.5 mg/lb], PO, q 12 h). After 10 days of treatment, peak and trough plasma concentrations of pimobendan were measured at 25, 196 and 715.97 ng/mL, respectively; the dosage was decreased to 0.25 mg/kg (0.11 mg/lb), PO, every 12 hours. No overt signs of toxicosis were detected. A sample was collected to reevaluate plasma pimobendan concentration after 30 days of treatment; results were not obtained prior to the patient's death but revealed a peak concentration of 16.8 ng/mL, with an undetectable trough concentration. The hawk was found dead 6 months after initial evaluation. Necropsy revealed cardiomegaly, but histologic examination did not reveal an inciting cause of cardiac dysfunction. CLINICAL RELEVANCE Cardiac disease in raptors may be underreported. Transcoelomic and transesophageal echocardiography and CT angiography provided useful information for the diagnosis of cardiac disease in the hawk of this report. PMID:27379599

  1. Pulmonary arterial hypertension in congenital heart disease: Correlation of radiologic index with hemodynamic data

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Hi [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    It is well known that pulmonary arterial hypertension in congenital heart disease is an important prognostic factor, as is pulmonary vascular resistance. So it is tempting to get certain radiologic index that could predict the presence and the degree of pulmonary arterial hypertension. A total of 152 cases of left to right shunt with pulmonary arterial hypertension and 50 cases of left to right shunt without pulmonary arterial hypertension is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between March 1981 and February 1983. Statistical analysis of plain radiography findings with the emphasis on the correction of radiologic index with the hemodynamic data. The results are as follows: 1. The incidence of pulmonary arterial hypertension is much less in arterial septal defect than other two disease groups of left to right shunt. 2. PA/T ratio correlates well with pulmonary arterial pressure (r=0.674), especially in mild pulmonary hypertension group. No correlation in moderate pulmonary hypertension group in significant level. 3. PA/T ratio is below 38 in total cases of normal control group and in 32 cases (21.0%) among 152 cases of pulmonary arterial hypertension group. 4. The average PA/T ratio in normal pressure group of left to right shunt is 35.3, which has no significant difference from that of normal control group. 5. The average CT ratio of pulmonary arterial hypertension group is 59.0, which is larger than 49.1 of normal control group. The CT ratio shows no correlation with the pulmonary arterial pressure in statistically significant level. 6. The higher the pulmonary arterial pressure, the larger the Rp/Rs value. The Rp/Rs in atrial septal defect is 0.193 in average, the lowest value in comparison with other two disease groups.

  2. Activity and practice of nuclear cardiology in the Czech Republic, 2001

    International Nuclear Information System (INIS)

    Radionuclide myocardial perfusion imaging (MPI) has been on the rise in Europe and the USA. Details on nuclear cardiology in the Czech Republic are not available as yet, as it is impossible to obtain comprehensive data from official registers owing to different methods of reporting and data evaluation. A questionnaire concerning nuclear cardiology activity and practice in 2001 was sent to all nuclear medicine departments in the Czech Republic. All 48 departments completed the questionnaire. In 2001, 50 planar and 54 tomographic (SPET) scintillation cameras were used. The average age of the SPET cameras was 5 years (13% of SPET cameras were >8 years old). Out of the 48 centres, 39 (81%) provided a nuclear cardiology service; the total number of cardiological studies was 15,740 in 2001 (1.5 studies/1,000 population/year). The most frequently employed method was MPI (81.7%), the frequency of which had increased by 10% compared with 2000; 26 of the 39 (67%) departments reported that MPI activity was increasing. Nevertheless, the Czech Republic nuclear cardiology activity remained below the European average (2.2/1,000 population in 1994) and, particularly, below activity in the USA (15/1,000 in 1997). The activity was rather unevenly spread. Whereas two centres with >1,000 studies/year accounted for 20% of the total MPI studies, 16 of 39 (41%) departments exhibited low activity (99mTc-MIBI (60% of total MPI), followed by 201Tl (21%) and 99mTc-tetrofosmin (19%). ECG-gated SPET was employed by 20/39 (51%) centres, of which 11 (28%) performed it as a standard examination; 39% of the total MPI studies included this technique. Thirteen percent (5/39) of the departments used attenuation correction, and 69% (27/39) of the departments used a prone projection. Equilibrium radionuclide ventriculography, with 2,317 examinations (14.7%), ranked second among all nuclear cardiology methods, followed by first-pass angiocardiography (406 studies, 2.6%) and 18F-FDG (163 studies, 1

  3. 双源计算机断层扫描在永存动脉干诊断中的应用%Clinical application of dual-source CT in diagnosis of persistent truncus arteriosus

    Institute of Scientific and Technical Information of China (English)

    冯越; 刘铁; 翟利浩


    Objectives To explore the clinical values of dual - source computed tomography ( CT) in diagnosis of persistent truncus arteriosus(PTA). Methods Seven patients (aged 7 days to 8 years, middle age 3.4 years) diagnosed as PTA by echocardiography underwent cardiac CT with dual-source CT machine. Two- and three-dimensional images were reformated by multiple planar reformation (coronal, sagital and oblique), maximum intensity projection and volume rendering. Of the 7 patients, 4 underwent angiocardiography. Results Qualitative and classification diagnosis were made through Dual-source CT in all the 7 cases. Dual-source CT visualized 28 concomitant anomalies while echocardiography visualized 24 in all the 7 cases. Conclusions Qualitalive and classification diagnosis can be made through Dual-source CT which contributes to the strategies and improvement of operations.%目的 探讨双源计算机断层扫面(computed tomography,CT)在永存动脉干诊断中的应用价值.方法 选择7例经超声心动图诊断为永存动脉干患者,年龄7d~8岁,中位年龄3.4岁.采用双源CT,心电门控下对比增强完成心脏检查,并在图像工作站完成多平面(MPR)、最大密度投影(MIP)和三维容积漫游(VR)处理.其中有4例进行心导管检查.结果 双源CT对7例永存动脉干均作出定性诊断和分型诊断,共发现合并畸形28处.超声心动图共显示24处.结论 双源CT可以对永存动脉干患者作出准确诊断及分型,并有助于临床手术方案的制订与完善.

  4. Influence of granulocyte colony-stimulating factor on cardiac function in patients with acute myocardial infarction and leukopenia after revascularization

    Institute of Scientific and Technical Information of China (English)

    GUO Shi-zun; WANG Ning-fu; ZHOU Liang; YE Xian-hua; PAN Hao; TONG Guo-xin; YANG Jian-min; XU Jian


    Background Granulocyte colony-stimulating factor (G-CSF) seems to improve cardiac function and perfusion when used systemically through mobilization of stem cells into peripheral blood, but results of previous clinical trials remain controversial. This study was designed to investigate safety and efficacy of subcutaneous injection of G-CSF on left ventricular function in patients with impaired left ventricular function after ST-segment elevation myocardial infarction (STEMI).Methods Thirty-three patients (22 men; age, (68.5±6.1) years) with STEMI and with comorbidity of leukopenia were included after successful primary percutaneous coronary intervention within 12 hours after symptom onset. Patients were randomized into G-CSF group who received G-CSF (10 μg/kg of body weight, daily) for continuous 7 days and control group. Results of blood analyses, echocardiography and angiography were documented as well as possibly occurred adverse events.Results No severe adverse events occurred in both groups. Mean segmental wall thickening in infract segments increased significantly at 6-month follow up compared with baseline in both groups, but the longitudinal variation between two groups had no significant difference (P >0.05). The same change could also be found in longitudinal variation of wall motion score index of infarct segments (P >0.05). At 6-month follow-up, left ventricular end-diastolic volume of both groups increased to a greater extent, but there were no significant differences between the two groups when comparing the longitudinal variations (P >0.05). In both groups, left ventricular ejection fraction measured by echocardiography ameliorated significantly at 6-month follow-up (P 0.05). When pay attention to left ventricular ejection fraction measured by angiocardiography,difference of the longitudinal variation between groups was significant (P=0.046). Early diastolic mitral flow velocity deceleration time changed significantly at 6-month follow-up in both

  5. 彩色多普勒超声心动图在老年动脉导管未闭封堵术中的价值%The value of color Doppler echocardiography in the elderly during the procedure of patent ductus arteriosus occlusion

    Institute of Scientific and Technical Information of China (English)

    侯传举; 朱鲜阳; 张端珍; 王琦光; 邓东安; 韩秀敏


    目的 探讨彩色多普勒超声心动图(CDE)在老年动脉导管未闭(PDA)封堵术中的价值.方法 封堵术前应用CDE筛选25例老年PDA适应证,彩色多普勒血流显像(CDFI)分流束血流信号估测PDA肺动脉端直径,与心血管造影对照,经统计学相关处理判断其正确性;连续波多普勒(CW)测量三尖瓣最大反流速度峰值,根据简化伯努利方程△P=4V2估算跨三尖瓣压力阶差,再加上右心房固有压力估测肺动脉压力,与心导管对照,经统计学相关处理判断其正确性;所有患者均行封堵术介入治疗,封堵术后再应用CDE判断封堵术疗效.结果 根据CDE特征筛选25例老年PDA实施封堵术全部获得成功,封堵术后CDE判断疗效满意.CDFI测量分流束血流信号估测PDA肺动脉端直径与心血管造影对照,呈正相关(r =0.71,P<0.001);CW估测肺动脉压力与心导管对照,呈正相关(r=0.63,P<0.001).结论 CDE在老年PDA封堵术中具有重要价值,封堵术前筛选适应证应用CDFI估测PDA肺动脉端直径和应用CW估测肺动脉压力是关键,封堵术后判断疗效应用CDFI观察有无过PDA残余分流很重要.%Objective To investigate the value of color Doppler echocardiography (CDE) in the closure of patent ductus arteriosus (PDA) in the elderly. Methods Before the occlusion, the indicantions for twenty-five elderly patients with PDA were screened by CDE. Using the shunt flow signal of color Doppler flow imaging (CDFI) , we estimated the pulmonary side diameter of PDA and compared with the angiocardiography and determined its accuracy through statistics. Using the continuous wave Doppler (CW), we measured peak velocity of tricuspid regurgitation and estimated crosstricuspid pressure gradient according to the simplified Bernoulli equation △P = 4V2 , together with the inherent right atrial pressure to estimate pulmonary artery pressure. Then, we compared cross-trtcuspid pressure gradient and pulmonary artery pressure

  6. Aneurisma subanular mitral: correção cirúrgica Submitral left ventricular aneurysm: surgical correction

    Directory of Open Access Journals (Sweden)

    Paulo M Pêgo-Fernandes


    Full Text Available O aneurisma subanular mitral é doença pouco conhecida em nosso país. Foi descrita, inicialmente, e é vista com maior freqüência na população negra das regiões sul e oeste da África. Parece relacionar-se a uma fraqueza da parede ventricular na área de implantação da cúspide posterior da valva mitral, levando à insuficiência dessa valva. É relatado o caso de homem de 20 anos, branco, com queixa de dispnéia e taquicardia. Foi internado devido a evolução para classe funcional IV. Após compensação clínica, apresentava, ainda, sopro sistólico (+++/++++ em área mitral. A radiografia de tórax mostrou aumento da área cardíaca (+++/++++ às custas de átrio e ventrículo esquerdo. O ecocardiograma, além do aumento dessas câmaras, revelou dilatação aneurismática na região posterior do ventrículo esquerdo, justa-valvar em relação à valva mitral, com sinais de incompetência severa, assim como a cineangiocardiografia. Submetido a cirurgia em 20/10/86, quando foi realizada ressecção do aneurisma, utilizando-se placas de pericárdio bovino para reconstrução. Foi feita, também, troca de valva mitral por válvula biológica. O paciente evoluiu bem, tendo recebido alta hospitalar no oitavo dia de pós-operatório. Atualmente, é assintomático, o ecocardiograma de controle revelou correção cirúrgica satisfatória.Submitral left ventricular aneurysm is a poorly known entity in our country; it has been described mainly in the southern and western African black populations. It appears to be related to a ventricular wall weakness in the area of implantation of the posterior mitral valve leaflet. A 20-year-old white man was admitted with complaints of dyspnea and palpitation. On admission he was in NYH A class IV. After medical treatment the cardiac area was very enlarged and there was a systolic murmur +++/++++. The twodimensional echocardiography as well as the angiocardiography revealed annular submitral left

  7. Study on imaging characteristics of color Doppler echocardiography on adult mirror image dextrocardia and deformity%成人镜像右位心及合并畸形彩色多普勒超声心动图特征研究

    Institute of Scientific and Technical Information of China (English)

    侯传举; 邹苏娅; 邓东安; 朱鲜阳; 韩秀敏; 刘剑立; 胡斌; 王巧玲


    目的:探寻成人镜像右位心及合并畸形彩色多普勒超声心动图(CDE)特征.方法:应用CDE检查31例成人镜像右位心及合并畸形,寻找CDE特征,所有病例均经心导管对照,21例手术证实.结果:根据CDE特征对29例做出正确诊断,诊断准确率93.5%,误诊2例.成人镜像右位心及合并畸形CDE特征明显;①成人镜像右位心合并11种先天性心脏病,其中ILL型右心室双出口(22.6%)、IDD型矫正性大动脉转位(19.4%)和法乐四联症(19.4%)多见,心室双人口(12.9%)和室间隔缺损(6.5%)少见,两腔心、二尖瓣闭锁、三尖瓣闭锁、全肺静脉异位引流、孤立性双腔右心室和孤立性二尖瓣裂隙(各3.2%)更少见;②成人镜像右位心无论合并那种先天性心脏病均为心房反位;③成人镜像右位心合并右心室双出口大动脉均为左转位;合并矫正性大动脉转位大动脉均为右转位;(4)成人镜像右位心合并肺动脉狭窄(93.5%)多见,肺动脉高压(6.5%)少见.肺动脉狭窄时,彩色多普勒血流显像显示过肺动脉五彩镶嵌射流束血流信号;⑤合并房间隔缺损和室间隔缺损时,彩色多普勒血流显像显示过房间隔或室间隔左向右或双向五彩镶嵌分流束血流信号.结论:成人镜像右位心及合并畸形CDE特征明显,应用CDE对成人镜像右位心及合并畸形可做出正确诊断,但检查者必须熟练掌握本病解剖.在探查手法上与正常位心脏明显不同,检查前阅读X线正位胸片对CDE正确诊断有帮助,并可提高检查效率.%Objective:To explore the characteristics of color Doppler echocardiography (CDE) adult mirror image dextrocardia and deformiry. Methods Thirty-one patients with adult mirror image dextrocardia and deformity were examined by CDE. All cases with mirror image dextrocardia and deformity underwent angiocardiography examination after CDE, twenty-one cases were proved by surgical operations. Results: Twenty-nine cases were diagnosed

  8. 镜像右位心及合并畸形彩色多普勒超声心动图特征和规律性研究%Atudy on Imaging Characteristics and Regularity of Color Doppler Echocardiography on Mirror Image Dextrocardia and Deformity

    Institute of Scientific and Technical Information of China (English)

    侯传举; 齐岩梅; 邓东安; 朱鲜阳; 韩秀敏; 卢迪


    Objective To explore the image characteristics and regularity of color Doppler echocardiography (CDE)on mirror image dextrocardia and deformity. Methods One hundred patients with mirror image dextrocardia and deformity were examined by CDE and the image characteristics and regularity of CDE were found. Ninety-five cases with mirror image dextrocardia and deformity underwent angiocardiography examination after CDE, Seventy-six cases were proved by surgical operations. Results Ninety-two cases were diagnosed correctly by the features of CDE imaging. The diagnostic rate of accuracy is 92 %,eight cases were misdiagnosed. The features in the mirrorimage dextrocardia and deformity CDE image characteristics and regularity were obvious. ① Mirror image dextrocardia usually combines twelve kinds congenital heart disease,among them, ILL type double outlet right ventricle(27 % )are common. IDD type corrected transposition of the great arteies( 17 % ),tetralogy of Fallot(16 % )and ventrcluar septal defect( 12 % )are not as common as the above. Double-inlet ventricle( 7 % ), tricuspid atresia( 5 % ), bilocular heart( 5 % ), ILL type complete transposition of the great arteies(4% ), mitral atresia(2 % ), isolated right ventricular outlet stenosis(2 % ), total anomalous pulmonary venous drainage( 2 % ), and isolated cleft mitral valve ( 1% ) are rare. ② Despite the diversity of combined congenital heart disease,all cases of adult mirror image dextrocardia have a common CDE characteristic of atria situs inversus. ③ adult mirror image dextrocardia combined double outlet right ventricle and complete transposition of the great arteies are left-transposition,combined corrected transposition of the great arteies are right-transposition.④ Mirror image dextrocardia combined pulmonary stenosis(80 % ) are common, pulmonary normal( 12 % ) and pulmonary hypertension(8%)are rare. ⑤ atral septal defect and ventricular septal defect color Doppler flow

  9. A Study on Imaging Characteristics of Color Doppler Echocardiography on Adult Dextrocardia with Cardiovascular Malformations%成人右旋心及合并畸形彩色多普勒超声心动图特征

    Institute of Scientific and Technical Information of China (English)

    侯传举; 李燕萍; 邓东安; 朱鲜阳; 韩秀敏; 刘剑立; 胡斌; 王巧玲


    Purpose To explore the imaging characteristics of color Doppler echocardiography(CDE) on adult dextrocardia with cardiovascular malformations.Materials and Methods Thirty patients with dextrocardia with cardiovascular malformations were detected by CDE and the imaging characteristics of CDE were investigated.All cases underwent angiocardiography examination as control.26 cases were proved by surgery.Results All cases were diagnosed correctly, according to CDE imaging features.The imaging features of CDE of adult dextrocardia with cardiovascular malformation are very obvious: ①Adult dextrocardia usually includes 4 kinds of congenital heart disease,among which type SLL corrective transposition of the great arteies are common (80%) ,type AⅢ double-inlet ventricle ( 10.0%) ,type SLL double outlet of right ventricle (6.7%) and isolated atrial septal defect (3.3%) is rare.②No matter which kind of congenital heart disease adult dextrocardia combined, CDE results all showed orthotopic heart.③Adult dextrocardia which combined corrective transposition of the great arteies,double-inlet ventricle and double outlet of right ventricle is left-transposition.④Among adult dextrocardia combined with complex congenital heart disease,many of them emerged pulmonary stenosis (93.3%) ,in which color Doppler flow imaging showed multicoloured enchase jet bouquet of blood flow signals through pulmonary artery.⑤In cases of atral septal defect and ventricular septal defect, color Doppler flow imaging showed left to right or bidirection multicoloured enchase shunt bouquet of blood flow signals across interatrial septum or interventricular septum.Conclusion The characteristics of CDE on adult dextrocardia and cardiovascular deformity are obvious.CDE can be used to diagnose this correctly, when the operators of CDE has an excellent demand of the anatomy of this disease.The exploration technique of the disease is obviously different from those of normal position heart