Detection and quantification of small left-to-right shunts by the phase-plane method.

Sixty-five pairs of indicator-dilution curves were obtained in five anesthetized dogs. After the injection of indocyanine dye into the left atrium, blood was simultaneously sampled through dichromatic cuvette densitometers from the femoral artery and the distal pulmonary artery. Dye-dilution curves were recorded from dogs with normal cardiovascular systems and after the surgical production of left-to-right shunts of different magnitudes. The percent of blood shunting was calculated according to the double sampling method and compared with a new method based on the deviation observed in the terminal portion of the indicator-dilution phase-plane loop. A high level of correlation was observed between both methods (r = 0.961). The phase plane shows its utility in the quantification of small left-to-right shunts. The use of only one sampling site at a peripheral systemic artery is an important advantage because there is complete mixture between shunted and unshunted blood.