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A method is described for localizing central right-to-left shunts by means of anesthetic ether injected through a cardiac catheter at various sites during cardiac catheterization. The presence and location of right-to-left shunts were correctly demonstrated in 42 of 43 patients in whom the diagnosis was later confirmed at operation or autopsy. The instance in which the site was interpreted incorrectly is explained. Three false-negative results were obtained from the test and reasons for these are also given. In our view the test is simple, safe, gives accurate results, allows immediate interpretation, and requires no special equipment. It has proved to be a most useful test for preliminary localization of shunts prior to selective angiocardiography.

The Identification of Right-to-Left Shunts in the Central Circulation by the Injection of Ether