The Use of Amipaque in Pediatric Angiocardiography

The outlining of abnormal cardiac structures in cases of congenital heart disease requires angiocardiography with multiple views of the heart during the intracardiac injection of iodinated contrast materials. The administration of large volumes of contrast material during such examinations can result in serious complications and in death. Particularly in small infants the physician is limited by the total amount of contrast material that he can inject with impunity. The deleterious effects resulting from these injections is caused to a large extent by the hyperosmolarity of the contrast material. The contrast materials currently used in angiocardiography are hyperosmolar monomeric agents. Previously obtained experimental data seem to indicate that nonionic contrast materials have less deleterious effects upon the myocardium when injected either directly into the coronary arteries or into the left ventricle. The purpose of our study was to compare Renografin 76, a hyperosmolar monomeric agent, with metrizamide, a nonionic agent, in a group of patients studied by angiocardiography to diagnose congenital heart disease.