Aortography in infants.

Making a diagnosis of a patency of a ductus arteriosus is often difficult in the first few months or first year of life. When the diagnosis is in doubt, one may profitably turn to angiocardiography for help. In this paper a method of demonstrating the patent ductus by the injection of contrast medium is described. The practical importance of the correct diagnosis is presented with reference to 4 cases treated surgically in the early months of life. Demonstration of coarctation of the aorta by this method is also discussed. TO ANYONE interested in angiocardiog-raphy in infants, the studies of Barclay and his co-workers' on the fetal circulation are most stimulating. Their investigations of the circulatory changes at birth, in lambs, provide a most useful background in studying similar processes in man. The clarity of their methods, using contrast media to demonstrate the ductus arteriosus, makes one wish it were possible to investigate human subjects as thoroughly. Although this is not possible, much can be done to investigate infants in the first year of life, and especially in the newborn period, by similar methods. Probably the chief value of the method to be described is in the study of patent ductus arteriosus, but one may also investigate co-arctation of the aorta and other anomalies of the aortic arch by this method. Patency of the ductus arteriosus has been demonstrated in infants by clinical means and by examination. Sometimes the presence of a continuous murmur in the pulmonary area indicates this anomaly. Such a murmur has been noted in a few premature babies. However, there may be simply a systolic murmur and the presence of a patent ductus can only be suspected.