The late phase of the venous angiocardiogram in the study of the vena cava pulmonary artery anastomosis

Two cases of congenital heart disease are presented in which cavopulmonary anastomosis was done; one with tricuspid atresia associated with patent ductus arteriosus, and the other is a case of probable transposition of the great vessels, pulmonary stenosis, mitral stenosis and small patent foramen ovale. A superior cavogram was done in both patients; in the second, before and after the creation of the atrial septal defect. The first superior cavogram revealed a good anastomosis, but with minimal shunt through it, while the second showed a large flow with a short angiocardiographic pulmonary transit time. Data obtained by superior cavograms are discussed and it is concluded that not only the early phase of the venous injection should be studied, but also the capillary and venous phase. Both furnish a great deal of information about the changes that may occur in the anatomic status of the pulmonary vascular tree in these cases. The technique for obtaining the greatest amount of details from both the anatomic and hemodynamic points of view is discussed.