Assessing cardiac anatomy with digital subtraction angiography.

The use of intravenous digital subtraction angiography in the assessment of patients with congenital heart disease is described. Intravenous digital subtraction angiographic techniques are particularly helpful in visually assessing left to right shunts in patients with atrial and ventricular septal defects and anomalies of pulmonary venous return. Digital subtraction angiographic techniques have also been used to quantitate the magnitude of left to right shunts and have been compared with radionuclide-determined pulmonary flow/systemic flow ratios (r = 0.89, p less than 0.0001). Digital subtraction angiographic techniques are particularly helpful in evaluating the right atrium, right ventricle and pulmonary arteries as well as the aorta and aortic arch. We have used digital subtraction angiographic techniques in the immediate and long-term postoperative evaluations of patients after congenital heart surgery. The safety of digital subtraction angiography lends itself to pediatric patients and can be performed on an out patient basis. Digital subtraction angiography provides significant anatomic information that has modified our traditional approach to patients with congenital heart disease.