angiocardiography – ABC CARDIOL

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Angiographic study of pulmonary circulation in tetralogy of Fallot with pulmonary atresia

Marco Aurélio Santos et al. Vitor Manuel Pereira Azevedo

OBJECTIVE: To identify the types of pulmonary vascular blood supply in tetralogy of Fallot with pulmonary atresia by use of hemodynamic study. METHODS: Fifty-six patients with tetralogy of Fallot and pulmonary atresia, and ages ranging from 20 days to 4 years, underwent cineangiocardiographic study with contrast medium injections in the following vascular structures: 1) wedged pulmonary vein; 2) aortopulmonary collaterals; 3) thoracic aorta; and 4) ductus arteriosus or systemic-pulmonary shunt. RESULTS: In the 56 patients studied, pulmonary blood was supplied as follows: in 15, by aortopulmonary collaterals; in 36, only by the ductus arteriosus; and in 5, by the ductus arteriosus and aortopulmonary collaterals. The patients were classified into 6 types depending on the type of pulmonary vascular perfusion and the presence or absence of vascular structures that compose the pulmonary circulation in tetralogy of Fallot with pulmonary atresia. CONCLUSION: This type of approach enables the obtainment of information necessary for the correct clinicosurgical management of patients, due to the great complexity and extreme variability of the pulmonary blood supply in tetralogy of Fallot with pulmonary atresia.

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Blood cell count, sodium, potassium, calcium, osmolality and viscosity, during pediatric angiocardiography with ioxaglate

Mauro Regis Silva Moura et al. Flávio Leboute Carlos Antonio Mascia Gottschall

PURPOSE: Children’s blood changes during angiocardiography may not be only due to the contrast media (CM). METHODS: We studied the presence and severity of changes in those parameters in 35 pediatric patients undergoing angiocardiography with ioxaglate aiming to identify independent variables responsible for those changes. Blood samples were taken at the beginning of the procedure (S1), at the end (S2) and two hours later (S3). RESULTS: Hematocrit: S1= 47.3±6.9%; S2= 40.7± 7.4% (p<0.001), (related to the CM volume r=0.37, p<0.05). Hemoglobin: S1= 15±2.1g%; S2= 13.2±2.4g% (p<0.001), and S3= 12.7±2.5g% (NS). White blood cell count: S1= 7940±3040 leukocytes/mm³; S2= 6950± 2700/mm³ (NS); S3= 10830±4690 leukocytes/mm³, (p<0.001). Procedure duration (r=0.38, p<0.05) and 5% glucose fluid given between S2 and S3 (r=0.49, p<0.05) were isolated. Sodium: S1= 134.5±0.4mEq/L; S2= 130.7±0.4mEq/L (p<0.001) (due to 5% glucose fluid injected, r=0.61, p<0.01). Potassium: S1= 4.22±0.45mEq/L, S2= 3.83±0.4mEq/L (p<0.001). Calcium: S1= 9.13± 1.03mg%; S2= 8.4±0.91mg/dL. (related to the CM, r=0.43, p<0.01.) Osmolality: S1= 293.3±12.5mOsm/kg; S2= 300.6±13.3mOsm/kg (p<0.001). Viscosity: S1= 3.36±0.81; S2= 3.09±0.74 (p<0.01); S3= 3.87±0.89, p<0.001. There was an indirect linear regression with the CM. CONCLUSION: There were profound differences among the dependent variables observed but the ioxaglate was partially related to changes in hematocrit/ hemoglobin, total calcium and viscosity. We failed to demonstrate significant regression coefficient between CM and changes in leukocytes, sodium, potassium, and osmolality.

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Angiographic study of pulmonary circulation in tetralogy of Fallot with pulmonary atresia

Blood cell count, sodium, potassium, calcium, osmolality and viscosity, during pediatric angiocardiography with ioxaglate

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