The right anterior oblique projection in the angiocardiographic demonstration of infundibular stenosis

At the present time, pulmonic stenosis is the most important single criterion in the evaluation of patients with cyanotic congenital malformations of the heart for the selection of those who may benefit from surgical measures. Furthermore, the accurate delineation of the infundibular portion of the right ventricle by angiocardiographic study may be of value in determining whether an aorticopulmonary anastomosis (1, 2) or an infundibular resection be undertaken (3). Dotter and Steinberg (4) have recently estimated that pulmonic stenosis is directly visualized in only one-half the cases of the tetralogy of Fallot. Cooley and his coworkers (5) have also reported that in many of these cases angiocardiography has provided only indirect evidence of pulmonic stenosis. With the development of biplane serial angiocardiography, which allows simultaneous right-angle exposures, greater precision and flexibility have been introduced into this procedure (6). While the number of cases examined by this technic has been s...