Radioactive tracers in congenital heart disease

Radionuclide angiocardiography is a useful method in the evaluation of patients with congenital heart disease, safely and nontraumatically. Physiologic variables such as transit times, cardiac output, left ventricular ejection fraction, stroke volume, end-diastolic volume can be measured accurately with this technique. An important application of radionuclide angiocardiography in children with congenital heart disease is in the detection, localization and quantification (pulmonary to systemic flow ratio) of intracardiac shunts and shunts between the great vessels. This technique has been found useful in the evaluation of the newborn infant with cyanosis, the patient with a cardiac murmur and the patient who has had cardiovascular surgery. Newer mobile gamma camera-computer systems permit the performance of radionuclide angiocardiography in several ill premature and newborn infants and patients during the early postoperative period. Specially designed magnifying collimators and the development of ultrashort-lived radionuclides should result in an overall improvement in the diagnostic capabilities of this technique and in a further reduction in the radiation dose.