Clinical uses of digital subtraction angiography for imaging anatomy immediately following heart operations in childhood
Vogel, M.; Sebening, W.; Schumacher, G.; Sauer, U.; Bühlmeyer, K.
Herz 10(4): 201-207
1985
ISSN/ISBN: 0340-9937 PMID: 3899884 Document Number: 257432
Within the last three years, digital subtraction angiography (DSA) was performed 60 times in 58 children with congenital heart disease (coarctation of the aorta, tetralogy of Fallot or transposition of the great vessels) in the immediate post-operative period to delineate residual defects. The DSA was carried out 3.7 +/- 1 days postoperatively with a total of 3.8 +/- 2.5 ml (0.47 +/- 0.2 ml/kg) Conray 70 or Solutrast 300 injected by hand into a catheter which generally had been positioned preoperatively at the transition between superior vena cava and right atrium. The outflow of the contrast medium was recorded on video tape and, additionally, single images of important anatomical details were obtained. In six patients with resected aortic coarctation, the patency of the entire aortic arch was documented with DSA; these patients had undergone surgery at a mean age of 3.3 +/- 4.8 years. Seven patients, with a mean age of 2.5 +/- 4.7 years, had tetralogy of Fallot, three additionally with pulmonary valve atresia; in all, postoperatively, the entire right ventricular outflow tract and the large pulmonary vessels could be demonstrated. In 45 patients with transposition of the great vessels, mean age 4.5 +/- 3.1 months, an atrial inversion with the Senning procedure was carried out; postoperatively, in all patients, the confluence of the superior and inferior vena cavae into the systemic venous portion of the atrium could be delineated. The pulmonary veins were visualized in one-third of the patients. In eight patients, DSA demonstrated obstruction at the opening of the superior vena cava into the atrium together with the collateral circulation via the azygos vein and the inferior vena cava.