Detection of pulmonary lesions in patients with congenital and acquired heart disease by wedge pulmonary arteriography

Abstract

Summary The WPA provides a clinical method for detecting pathologic lesions of the small pulmonary arteries in patients with congenital or acquired heart disease. Abrupt narrowing in the caliber of 300 to 900 micra arteries is the characteristic finding in patients with severe occlusive disease of the small pulmonary arteries, as is seen in late-stage large ventricular septal defect and functionally related cardiac defects. Decreased arborization and background filling are seen in proportion to the increase in pulmonary vascular resistance in mitral stenosis. In atrial septal defect abundant arborization and background filling are found in proportion to the magnitude of the pulmonary flow.