Wedge Pulmonary Arteriography in Congenital Heart Disease

The importance of angiocardiography in the study of the pulmonary vascular tree is generally accepted. Peripheral or selective angiocardiography has been fruitful in furnishing a panoramic view of the pulmonary artery and its main branches and the pulmonary veins. It has indications and advantages, but unfortunately the superposition of other parenchymal vessels in the frontal projection makes accurate information about the small pulmonary vessels impossible. While in some cases abnormalities occur at the main pulmonary artery or its large branches, in others the lesion involves primarily the small arteries or arterioles. To obtain better details, injection has been made in the pulmonary artery branches in “free” (1–9) or in “jammed” (10) position. The latter has proved the best method to date of delineating the anatomical status of the small arteries, arterioles, and capillary network. Correlation between the roentgenographic pattern and the microscopic picture of the segment injected has been accurately...