Clinical relevance of video-angiocardiometry in the pediatric age group.

Routine quantitative assessment of diagnostic angiocardiograms of children with congenital heart disease is only practiced by a few groups. General availability of high quality computer technology and software as well as the increasing surgical treatment of complex congenital heart diseases warrants a critical review of the potential of quantitative angiocardiography in the pediatric age group. Video techniques allow recording and evaluation of the respective anterior-posterior and lateral projections side by side on one TV-field, obviating time consuming handling of conventional films with separately recorded projections. Reproducibility of this observer dependent technique is excellent. The statistical error of the clinically important normal values during the period of growth is in the range observed for other biological methods and allows separation of normal and overloaded ventricles. Angiocardiometric parameters quantitatively describing ventricular spatial orientation, shape, size, and function characterize overloaded left and right ventricles of simple congenital heart diseases. For the assessment of the severity, prognosis, and indication for an operation in an individual patient angiocardiometry in most cases adds only information which has to be evaluated in conjunction with that of clinical examinations and other laboratory techniques. Angiocardiometry is of particular value - also for the individual patient - in more complex congenital heart diseases for the monitoring of ventricular size and function before and after one- or more-stage operations. Thus deficiencies of operative methods can be delineated and may lead to improvement and introduction of new ones. Application of contrast medium and X-ray saving digital subtraction methods, possibly in conjunction with semi-automated contour detecting techniques, will allow an even more detailed angiocardiometric evaluation with broader acceptance in pediatric cardiology.