Society of University Surgeons| Volume 52, ISSUE 1, P77-87, July 1962

Double contrast left cardioangiography with the use of carbon dioxide

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      Double contrast cardioangiography offers significant aditional information about the in vivo status of the cardiovascular system. Extensive experimental studies have resulted in a safe technique for performing such studies on either the left or right sides of the circulatory system. The method consists of preloading the injection catheter (usually selectively positioned) with contrast a medium such as 75 per cent Hypaque, and a specially designed gas injector unit is utilized to deliver the CO2 in a controlled manner in order to disperse the contrast medium evenly and widely onto the vessel walls for maximum detail.
      Safe and reliable methods have been developed for utilizing “double contrast and CO2 angiography” for aortic valvulography, aortography, renal arteriography, percutaneous femoroilioarteriography, including the small vessels below the knee, and coronary arteriography. For the latter procedure, acetylcholine for asystole and pacemaker stimulation for controlled restoration of heartbeat, are incorporated as added safety measures, while ostia, lumina, and ramifications of coronaries are outlined in double contrast. The gas control injection unit insures maximum efficiency of the two media, thereby permitting use of small quantities of both and it also obviates dangers of air contamination. Direct vision of luminal or valvular lesions, as contrasted to obscured, indirect, and usually only functional information of current cardioangiograms, offers the diagnostician and surgeon intimate knowledge of anatomicopathologic changes before treatment or surgery.
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        • Bilgutay A.M.
        • Lillehei C.W.
        A new method for coronary arteriography by means of acetylcholine asystole with controlled return of heart rate using a cardiac pacemaker.
        J. A. M. A. June, 1962; vol. 180
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        • Paul R.E.
        The safety of intravascular CO2 and its use for roentgenologic visualization of intracardiac structures.
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        • Stevenson J.K.
        • Figley M.M.
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        Exploration into the possibilities of venous inflow occlusion during angiocardiography.
        in: ed. 4. S. Forum. 11. 1960: 145