Axial cineangiography in congenital heart disease. Section I. Concept, technical and anatomic considerations.

Abstract

Cineangiographic axial techniques were designed to overcome the limitations of conventional angiography in the diagnosis of congenital heart disease. Two basic patient (or equipment) maneuvers are involved; 1) long axis of the heart is aligned perpendicular to the X-ray beam, and 2) rotation of patient results in the heart being radiographically sectioned at 30 degree angles. To accomplish this with fixed vertical and horizontal X-ray tubes, three positions were developed: 1) "hepato-clavicular," "4 chamber," 2) "long axial oblique," 3) "anterior-posterior axial." A fourth, the "sitting-up" projection is discussed. The hepato-clavicular position profiles the posterior ventricular septum and atrial septum, separates the A-V valves, places the four cardiac chambers en face, and clarifies mitral valve-semilunar valve and outflow tract relationships. The long axial oblique profiles the anterior ventricular septum, left ventricular outflow tract, aortic valve-anterior mitral valve leaflet. The sitting-up view visualizes the bifurcation of the pulmonary trunk and separates true pulmonary arteries from systemic collaterals.

Double outlet from chambers of left ventricular morphology.

“…Selective left ventriculography has been considered (Pacifico et c;l., 1973) the best way of demonstrating the preserce of DOLV, but right ventriculography can also be of value in some cases (Brandt et al, 1976). In our view, a number of projections, including those selective for the anterior part of the interventricular septum (hepatoclavicular technique and long axis oblique view of Bargeron et al, 1977), may be necessary, particularly in cases of transposition of the great arteries with subaortic ventricular septal defect (Quero Jimenez and Perez Martinez, 1974) or anatomically corrected malposition (Otero Coto, 1977).…”

History of Coronary Angiography

“…Instantaneous playback of tape-recorded images has afforded great utility and safety in determining whether desired anatomic and physiologic information has been attained, thereby precluding additional unnecessary studies (Figure 8). The introduction of angled views for the study of congenital and acquired heart disease was an important technical innovation [19]. Equipment companies responded with engineering advances that made angled views relatively simple: the C-arm, the U-arm, and the parallelogram.…”

Experimental Evaluation of Three Biomaterials for Replacement of the Pulmonary Artery Branches

“…The angiographic evaluation was carried out with an apparently adequate, if not outstanding, radiographic and 35-mm cineangio apparatus. It is our feeling that some imprecision in the estimation of the diameter of the angioplastic segments was predomi nantly due to intrinsic difficulties related to the radiologic anatomy of the canine thorax and pulmonary vasculature; principally the superimposition of the main pulmonary ar tery and of the initial segments of the two main branches requires, perhaps even more than in man, the use of special projections [3]. Nevertheless the correlation between the radiologic and the hemodynamic data was good in a large majority of cases.…”