[Interventions on the heart and large vessels without prior heart catheterization].

Between May 1983 and May 1987, 161 children of all age groups underwent surgery for congenital cardiac malformations without prior cardiac catheterization and angiocardiography. Their diagnoses were established by clinical investigation, electrocardiogram, chest X-ray and cross-sectional echocardiography only in all cases. The most common surgical procedures were ligation of a patent ductus arteriosus (n = 68), correction of aortic coarctation (n = 28), balloon atrial septostomy (n = 27), and closure of an atrial septal defect (n = 23). To prove the efficiency and accuracy of this method all patients with cardiac malformations surgically treated over the same time period, of the same age groups and with the same diagnoses, who had undergone routine preoperative cardiac catheterization and angiocardiography, were reviewed with regard to the attained results, which were compared with those of the non-invasive group. No patient in either group died postoperatively due to an incorrect or incomplete preoperative diagnosis. There were problems in the group diagnosed by echocardiography only in assessing the permeability of the tricuspid valve in cases of pulmonary atresia with a hypoplastic right ventricle and in assessing the operability of patients with a complete aterioventricular canal. A large group of congenital cardiac malformations can, however, be safely operated on the basis of non-invasive preoperative diagnoses only.