Measurement of pulmonary artery pressure in cyanotic heart disease using selective coronary artery cannulation techniques.

The measurement of pulmonary artery pressure and resistance is crucial in the management of older patients with cyanotic congenital heart disease. This is especially important in patients who have had previous palliative surgery or known right ventricular outlet obstruction.' The ability to measure pulmonary artery pressure is often hampered by the presence of significant derangements of cardiac anatomy.2 Recently, in a patient who presented with complex cyanotic heart disease and a previous Blalock procedure, techniques developed for coronary balloon angioplasty3 4 and streptokinase infusion" of the coronary arteries were used to measure pulmonary pressure through the Blalock anastomosis.