Evaluation of patients with pulmonary atresia and intact ventricular septum by double catheter technique

Abstract

Accurate definition of the site and length of the atretic segment in the patient with pulmonary atresia and intact ventricular septum is of prognostic and surgical significance. A double catheter technique was developed to allow precise localization of the site of atresia, whether valvular, infundibular, or both. Simultaneous opacification of the pulmonary artery by way of the ductus arteriosus or systemic to pulmonary arterial anastomosis by one catheter and the right ventricle by the second catheter was accomplished in five patients with pulmonary atresia, severe hypoplasia of the right ventricle and intact ventricular septum. The patients were 2 days to 17 months of age and weighed 3,200 to 9,200 g at the time the technique was applied. In these patients, the site of atresia proved to be valvular in one, and both valvular and infundibular in four. The double catheter technique is also applicable to patients with ventricular septal defect and acquired or congenital pulmonary atresia who have had palliative shunts, and to patients with complex transpositions and pulmonary atresia.