Improved cineangiographic evaluation of hypertrophic cardiomyopathy by caudocranial left anterior oblique view.

Seven patients with hypertrophic cardiomyopathy and one with discrete subaortic stenosis were studied with axial left ventriculography (caudocranial left anterior oblique view). In addition to the angiographic findings described on conventional views, the mitral valve, ventricular septum, and posterior left ventricular wall were better profiled than with conventional views and thus better evaluated. Systolic anterior motion of the anterior leaflet of the mitral valve was readily identifiable, which is usually not the case in nonangled views. From our experience, we strongly recommend that caudocranial left ventriculography be the procedure of choice in patients suspected of left ventricular outflow tract abnormalities and that biventricular angiography be abandoned for diagnostic purposes.