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Radioisotopic Angiocardiography: Findings in Congenital Heart Disease

Stanford University School of Medicine, Stanford, California

Correspondence: For reprints contact: Joseph P. Kriss, Div. of Nuclear Medicine, Stanford University, School of Medicine, Stanford University Medical Center, Stanford, Calif. 94305.

ABSTRACT

Intravenous radioisotopic angiocardiography with ^99mTc-pertechnetate has been performed on 30 patients with congenital heart disease using the scintillation camera and the variable time-lapse videoscintiscope. Seven patients were studied before and after surgical treatment. The following different lesions were encountered: atrial septal defect, ventricular septal defect, tetralogy of Fallot, pulmonic stenosis, aorto-pulmonary window, complete transposition of the great vessels, corrected transposition, idiopathic hypertrophic subaortic stenosis, aneurysm of the sinus of Valsalva, post-valvular aortic stenosis, coaraction of aorta, and left superior vena cava. Abnormal and distinguishable scintiphotographic patterns were obtained in nearly all of the patients studied. The sensitivity of the method, especially in the assessment of septal defects, was excellent; e.g., capable of indicating the presence of left-to-right shunts associated with a pulmonary artery-to-systemic flow ratio of only 1.2. The procedure has been especially helpful in ruling out recurrence of shunts in surgically treated patients with persistent or developing cardiac murmurs. Because of its simplicity, speed, safety, and immediate clinical relevance of the data, we recommend that the test be performed as a screening procedure before cardiac catheterization or selective contrast angiography.