Altman, Adele R.; Kahn, Robert E.; Borrelli, Frank J.
March 1967
Angiology;Mar1967, Vol. 18 Issue 3, p150
Academic Journal
Because of the high complication rate encountered in performing intracardiac selective angiocardiography in infants using the concentrated and hence viscid radiopaque agents, 50 per cent sodium diatrizoate was employed in 65 consecutive infants under 20 lb for a total of 101 intracardiac injections, including 7 left ventricular injections. A comparison was made between this group and an earlier series consisting of 28 patients, for a total of 53 intracardiac injections of a more concentrated opaque. It was concluded that the administration of 2.5 to 9 ml of 50 per cent sodium diatrizoate, rarely exceeding 1 ml per kg, has resulted in excellent opacification of intracardiac structures. The low viscosity of this medium has 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 one to two cardiac cycles. This contrast medium has proven 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 has given 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 has been obtained following right ventricular injections.


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