Transvenous Selective Coronary Angiography via Ventricular Septal Defect in Tetralogy of Fallot

In order to determine the applicability of a new technique, we performed transvenous selective coronary angiography via ventricular septal defect in 62 patients with tetralogy of Fallot between April ı994 and July 1995. The patients' age ranged from ı to 13 years (mean 3.ı6 ± 2.ı7), and weight ranged from 6.7 to 32 kg (mean 12 ± 4.44). 5.2 or 6F 4 cm angled "soft type" right Judkins catheter (JR4) and hydrophilic guide-wire were used for entering the aorta from the right ventricle via a sheath placed in the femoral vein. Right coronary artery was catheterized with 5.2-7F JR4 catheters and Ieft coronary artery with 5.2-7F JR4 or 5.2-7F internal mammarian artery (LIMA) catheters. The right coronary arteriography was successfully performed in all, and left coronary arteriography was successful in (56.95 %) cases. Total catheterization time (for diagnosis of tetralogy of Fallot + selective coronary arteriography) ranged from 15 to 65 (mean 34.4 ± 14.8) and fluoroscopy time varied from 3 to 29.2 (mean 1 I .8 ± 6.2) min u tes. For the catheterization of the right coronary artery 6F JR4, and for the catheterization of the Ieft coronary artery 7F LIMA ca theter has proved more successful. During entrance from the right ventricle to the aorta transient right bundle branch block was observed in 2 patients and during coronary angiography, ST changes occurred in 7 patients and transient bradycardia occurred in 3 patients. We conclude that transvenous selective coronary angiography via ventricular septal defect is a safe and easily applicable method for infants and children w ith tetralogy of Fallot