A Comparative Study of the Detection of Cardiovascular Shunts by Oxygen Analysis and Indicator Dilution Methods
Authors: ALBERT L. HYMAN
Journal: Annals of Internal Medicine (1962)

Article1 April 1962A Comparative Study of the Detection of Cardiovascular Shunts by Oxygen Analysis and Indicator Dilution MethodsALBERT L. HYMAN, M.D., F.A.C.P., WILLIAM MYERS, M.D., KENNETH HYATT, M.D., ARTHUR C. DEGRAFF JR., M.D., ANTONIO C. QUIROZ, M.D.ALBERT L. HYMAN, M.D., F.A.C.P., WILLIAM MYERS, M.D., KENNETH HYATT, M.D., ARTHUR C. DEGRAFF JR., M.D., ANTONIO C. QUIROZ, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-535 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe rapid advances in cardiovascular surgery have placed an added burden upon the cardiologist's diagnostic acumen. Identification and precise localization of even small shunts have become important problems in clinical medicine. Surgical correction of one lesion may permit a second, previously unsuspected, lesion to reach hemodynamically significant proportions. Repair of this second lesion may not be possible at that moment for lack of preoperative preparation for cardiopulmonary bypass. Indeed, errors in diagnosis by cardiac catheterization have led to needless thoracotomy in which the suspected lesion was not found. Recognition of the inadequacy of the oxygen step-up technique for identifying and...References1. STEWART GN: Researches on the circulation time and on the influences which affect it. IV. The output of the heart. J. Physiol. (Lond.) 22: 154, 1897. CrossrefGoogle Scholar2. HAMILTONMOOREKINSMANSPURLING WFJWJMRG: Simultaneous determination of the pulmonary and systemic circulation time in man and a figure related to cardiac output. Amer. J. Physiol. 84: 338, 1928. CrossrefGoogle Scholar3. KINSMANMOOREHAMILTON JMJWWF: Studies on circulation; injection method; physical and mathematical considerations. Amer. J. Physiol. 89: 322, 1929. CrossrefGoogle Scholar4. HAMILTONMOOREKINSMANSPURLING WFJWJMRG: Studies on circulation; further analysis of injection method, and of changes in homodynamics under physiological and pathological conditions. Amer. J. Physiol. 99: 534, 1932. CrossrefGoogle Scholar5. SANDERS RJ: Use of radioactive gas (Kr85) in diagnosis of cardiac shunts. Proc. Soc. Exp. Biol. Med. 97: 1, 1958. CrossrefMedlineGoogle Scholar6. CASEHORLEYKEATINGKEATINGSACHSLOEFFLER RBHWRPHLEE: Detection of circulatory shunts by use of radioactive gas. Proc. Soc. Exp. Biol. Med. 97: 4, 1958. CrossrefMedlineGoogle Scholar7. MORROWSANDERSBRAUNWALD AGRJE: The nitrous oxide test, an improved method for detection of left to right shunts. Circulation 52: 284, 1958. CrossrefGoogle Scholar8. PFAFFFROMMERMORROW WWPAG: Ascorbic acid dilution curves in cardiovascular diagnosis. Surg. Forum 11: 147, 1960. MedlineGoogle Scholar9. CLARKBARGERON LCLM: Detection and direct recording of left to right shunts with the hydrogen electrode catheter. Surgery 46: 797, 1959. MedlineGoogle Scholar10. HYMANHYMANQUIROZGANTT ALEJACJR: Hydrogen platinum electrode system in detection of intravascular shunts. Amer. Heart J. 61: 53, 1961. CrossrefMedlineGoogle Scholar11. WOODSWANMARSHALL EHHJHW: Technical and diagnostic applications of dilution curves recorded simultaneously from the right side of the heart and from the arterial circulation. Proc. Mayo Clin. 33: 536, 1958. MedlineGoogle Scholar12. QUIROZDEGRAFFHYMAN ACACAL: Dye dilution curves recorded from the right side of the heart: application in congenital intracardiac shunts. Santo Tomas J. Med. 15: 173, 1960. Google Scholar13. TAYLORSHILLINGFORD SHJP: Clinical application of coomassie blue. Brit. Heart J. 21: 497, 1959. CrossrefMedlineGoogle Scholar14. HYMANHYMANQUIROZGANTT ALESACJR: Hydrogen platinum electrode system in the detection of intravascular shunts. Surg. Forum 11: 450, 1960. MedlineGoogle Scholar15. CLARKMANSFIELD LW: The Determination of Hydrogen Ions, Williams & Wilkins Co., Baltimore, 1920. Google Scholar16. HYMAN EJ: Cause of failure in the artificial heart. Trans. Amer. Soc. Artificial Intern. Organs 5: 257, 1959. Google Scholar17. ROUGHTONSCHOLANDER FJPF: Microgasometric estimation of blood gases: oxygen. J. Biol. Chem. 148: 541, 1943. CrossrefGoogle Scholar18. HYMAN ES: A linear system for quantitating hydrogen at a platinum electrode. Unpublished material. Google Scholar19. HYMANLEVYBAGNETTOORDWAY ALLRNV: Application of newer diagnostic methods in congenital heart disease. New Orleans Med. Surg. J. 103: 1, 1950. MedlineGoogle Scholar20. PRESTONORDWAY SHNK: Observation of arterial oxygen content in children during inhalation of air and 100% oxygen. Amer. J. Physiol. 152: 696, 1948. CrossrefMedlineGoogle Scholar21. LEVYFOWLERKIRKLEYALBERTMARTINEZ LRDHJL: Multiple hydrogen electrode catheter for determination of cardiac shunts. New Engl. J. Med. 264: 1356, 1961. CrossrefMedlineGoogle Scholar22. VOGELGROVERBLOUNT JHRFSG: Detection of the small intracardiac shunt with the hydrogen electrode. Unpublished material. Google Scholar23. BURCHDEPASQUALE GENP: The electrocardiogram, vectorcardiogram and ventricular gradient in congenital ventricular septal defect. Amer. Heart J. 60: 195, 1960. CrossrefMedlineGoogle Scholar24. BURCHDEPASQUALE GENP: The electrocardiogram, vectorcardiogram, and ventricular gradient in pulmonary stenosis with atrial septal defect. Unpublished material. Google Scholar25. DEPASQUALEBURCH NPGE: The electrocardiogram, vectorcardiogram, and ventricular gradient in isolated congenital pulmonary stenosis. Circulation 21: 181, 1960. CrossrefMedlineGoogle Scholar26. DEPASQUALEBURCH NPGE: The electrocardiogram, vectorcardiogram, and ventricular gradient in the tetralogy of Fallot. Circulation 24: 94, 1961. CrossrefMedlineGoogle Scholar27. BARGERONCLARKLYONS LLCC: Use of an electrode for continuously recording intracardiac pO2 changes in cardiac catheterizations. Circulation 24: 881, 1961. Google Scholar28. BARGERONCLARK LLC: Personal communications. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New Orleans, LouisianaFrom the Cardiopulmonary Laboratories, Departments of Medicine and Surgery, Tulane University School of Medicine, and Charity Hospital, New Orleans, Louisiana.Supported in part by United States Public Health Service Grant H2826 and the Louisiana Heart Association.Requests for reprints should be addressed to Albert L. Hyman, M.D., Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans 12, Louisiana. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHydrogen inhalation for detecting intracardiac left-to-right shunting in adultsDetection of intracardiac left-to-right shunting in adults: A prospective analysis of the variability of the standard indocyanine green technique in patients without shuntingRadionuclide ventriculography: A noninvasive method for the detection and quantification of left-to-right shunts in atrial septal defectIV. EVALUATION OF DICHROMATIC EARPIECE DENSITOMETRY IN CHILDREN WITH LEFT-TO-RIGHT SHUNTSMèthodische Fortschritte und neue Ergebnisse indirekter photometrischer Untersuchungen bei Herz- und KreislaufkrankenKrypton-85 in the Detection of Intracardiac Left-to-Right ShuntsValvular insufficiency occurring during cardiac catheterizationFarbstoffverdünnungsuntersuchungen mit Hilfe der transseptalen Punktion des linken HerzensThe effect of acute pulmonary embolus upon cardiopulmonary hemodynamicsGaseous Diffusion from Alveoli to Pulmonary Vessels of Considerable Size 1 April 1962Volume 56, Issue 4Page: 535-544KeywordsCardiology and cardiovascular diseasesCardiopulmonary bypassCatheterizationHeartHospital medicineLesionsMedical servicesOxygenSurgeryThoracotomy Issue Published: 1 April 1962 Copyright & PermissionsCopyright ©, 1962, by The American College of PhysiciansPDF downloadLoading ...