ANGIOCARDIOGRAPHIC DETERMINATION OF THE SIZE OF THE LEFT VENTRICLE IN CONGENITAL HEART DISEASE

¹ Senior Scientist, National Children's Cardiac Hospital, Miami, Florida; Visiting Professor of Pediatrics, University of Miami School of Medicine, Miami, Florida; Former Head Professor of Pediatrics, University of Havana School of Medicine, Havana, Cuba; Honorary Fellow of the American College of Radiology
² Associate Professor, Department of Pediatrics, University of Miami School of Medicine, Miami, Florida; Associate Professor, Department of Medicine, University of Miami School of Medicine, Miami, Florida; Clinical Director, National Children's Cardiac Hospital, Miami, Florida

1. The end diastolic area of the left ventricle in frontal angiocardiograms has been determined in 13 normal cases and the results were plotted against the body surface area (B.S.A.) (m.²). Regression lines were thus obtained.

2. This area was also estimated in 75 cases of congenital heart disease. Twentyfive were cases of ventricular septal defect; 18 of atrial septal defect; 20 of puirnonary stenosis; and 12 of tetrabogy of Fallot. Regression lines for each group were obtained.

3. In anteroposterior projection the normal value may be found by multiplying the body surface area (B.S.A.) (m.²) by 30.1 cm.².

4. In uncomplicated ventricular septal defect, the end diastolic areas of the left ventricle were larger than normal. In the presence of high pulmonary resistance, most cases showed a left atrium of smaller size than normal. Eighty per cent of the cases of ventricular septal defect, 44 per cent of atrial septal defect, 30 per cent of pulmonary stenosis and 58 per cent of tetralogy of Fallbot were found to have normal or above normal values.

5. When the normal regression line was compared with those of each group of congenital heart disease (C.H.D.), it was found that cases of ventricular septal defect showed lines above those of normal, while cases of pulmonary stenosis, atrial septal defect and tetralogy of Fallot had below normal lines.

6. The described method for the estimation of the size of the left ventricular cavity has allowed the correlation of the pulmonary blood flow (P.B.F.) (L/min.), or the pulmonary flow index (P.F.I.) (L/min./m.²) with the end diastolic area of the left ventricle, either corrected or uncorrected for the B.S.A. The differences found in cases of atrial septal defect are discussed.

7. The method is accurate and easy to perform. Single plane studies only are required. Pathophysiologic studies can be performed with correlation of different variables. This cannot be done when the size of the left ventricle is estimated by other methods.

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