Long-Term Anticoagulant Treatment in Coronary Disease

Abstract

Because of the high complication rate encountered in performing intracardiac selective angiocardiography in infants using the concentrated and viscid radio-opaque agents, 50% sodium diatrizoate was employed in 65 consecutive infants under 20 lb for a total of 101 intracardiac injections, including 7 left ventricular injections. This group was compared with an earlier series consisting of 28 patients, for a total of 53 intracardiac injections of a more concentrated opaque. The administration of 2.5 to 9 ml of 50% sodium diatrizoate, rarely exceeding 1 ml/kg, resulted in excellent opacification of intracardiac structures. The low viscosity of this medium yielded an increased flow rate at significantly decreased injection pressures, assuring delivery of the total bolus in 0.5 to 0.8 sec, i.e., within approximately 1 to 2 cardiac cycles. This contrast medium was successful in all infants under 15 lb, independent of age. It may be employed in babies between 15 to 20 lb, whose hearts are normal in size or only slightly enlarged; for infants weighing over 20 lb a more concentrated medium is preferred. No major complications were encountered. This technique gave good results even in the presence of large left-to-right intracardiac shunts, and good opacification of the left heart chambers from pulmonary venous return flow was obtained following right ventricular injections.