CHAPTER 7 HEART CATHETERIZATION

Summary 1. Heart catheterization was performed before shunt operation for morbus caeruleus in 101 cases. Only in 42 of these was it possible to guide the catheter into the pulmonary artery in order to measure the pressure there. After operation 89 cases were studied by heart catheterization and in 44 cases the pulmonary artery pressure could be measured. The difficulties in reaching the pulmonary artery arose from the anomalous anatomy. 2. In 15 cases pulmonary artery pressure could be compared before and after operation. Preoperatively the readings were normal or subnormal. Postoperatively there was statistically significant increase in the systolic and diastolic pressures. These were still within the limits of normal, however, except in 2 patients with slight to moderate hypertension, probably as the result of the increased flow to the pulmonary artery via the anastomosis. 3. Among the postoperatively catheterized patients without comparable preoperative measurements, 2 had slight pulmonary hypertension; the systolic pressure did not exceed 40 mm Hg. Comparison between all the preoperative and all the postoperative readings of pulmonary artery pressure showed probable increase of the mean systolic and diastolic pressures, but the difference was not statistically significant. The normal limits of variation were not exceeded. Only one patient with hypertension and clinical signs of functioning anastomosis revealed appreciable cardiac enlargement in the roentgenograms. 4. The systemic arterial oxygen saturation could be compared preoperatively and postoperatively in 69 cases. The saturation tended to be distinctly higher after operation, and in some cases the readings during rest were within the limits of normal variation. 5. Polyglobulia was found to be related to systemic arterial oxygen saturation and diminished as the oxygen saturation increased.