Pulmonary wedge angiography for the evaluation of the pulmonary vascular bed in congenital heart disease.

Pulmonary wedge angiograms (PWA) were analyzed qualitatively and quantitatively to evaluate the pulmonary vascular bed in 40 patients with congenital heart disease. The patients were divided into four groups: group 1, normal pulmonary hemodynamics; group 2, increased pulmonary blood flow; group 3, pulmonary hypertension (PH); and group 4, PH with elevated pulmonary vascular resistance. The PWA were analyzed for tapering, pulmonary circulation time (PCT) index, and vascular image. The tapering was normal in groups 1 and 2 and was more rapid in groups 3 and 4. The PCT index was slightly lower in groups 3 and 4 than in groups 1 and 2. With 100% oxygen, the tapering became less severe and the PCT index increased in group 3. However in group 4, these parameters did not improve with 100% oxygen, suggesting that more advanced vascular changes had developed. These studies confirm the usefulness of the PWA in evaluating the pulmonary vascular bed of patients with congenital heart disease and PH.