Summary
Countercurrent aortography via a peripheral artery was used to clarify the aortic arch anatomy in 25 infants in whom cross-sectional and Doppler evaluation was inconclusive. Ages ranged from 3 days to 11 months (median 9 days), and 80% were neonates. The suspected diagnosis was aortic coarctation in 21 infants, interrupted aortic arch in two, recoarctation in one, and vascular ring in one. A countercurrent aortogram provided adequate diagnostic information in 24 infants. A diagnosis of coarctation was confirmed in 15, interruption of the aortic arch in two, and vascular ring in one. In six infants countercurrent aortography excluded the presence of anomalies of the aortic arch. In only one infant, who had an anomalous origin of the right subclavian artery from the descending aorta, did this technique fail to provide adequate information. The only complication observed was transient ischemia of the arm in one patient.
Countercurrent aortography is a minimally invasive procedure that can provide adequate angiographic information without the need for cardiac catheterization in patients with inconclusive echocardiographic evaluation. Injection into a right upper limb artery is preferred, because it gives better opacification of the ascending and transverse aortic arch than injection into a left one.
Similar content being viewed by others
References
Baker EJ, Ayton V, Smith MA, et al. (1989) Magnetic resonance imaging of coarctation of the aorta in infants: Use of a high field strength.Br Heart J 69:97–101
Brus F, Witsenburg M, Hofhuis WJD, Hazelzet JA, Hess J (1990) Streptokinase treatment for femoral artery thrombosis after arterial cardiac catheterisation in infants and children.Br Heart J 63:291–294
Castellanos A, Pereiras R (1939) Counter-current aortography.Rev Cubana Cardiol 2:187–205
Duncan WJ, Ninomiya K, Cook DH, Rowe RD (1983) Noninvasive diagnosis of neonatal coarctation and associated anomalies using two-dimensional echocardiography.Am Heart J 106:63–69
Girod DA, Hurwitz RA, Caldwell RL (1982) Heparinization for prevention of thrombosis following pediatric percutaneous arterial catheterisation.Pediatr Cardiol 3:175–180
Houston AB, Simpson IA, Pollock JC, Jamieson MPG, Doig WB, Coleman EN (1987) Doppler ultrasound in the assessment of severity of coarctation of the aorta and interruption of the aortic arch.Br Heart J 57:38–43
Huhta JC, Gutgesell JP, Latson LA, Huffines FD (1984) Two dimensional echocardiographic assessment of the aorta in infants and children with congenital heart disease.Circulation 70:417–424
Qureshi SA, Ettedgui JA, Jones ODH, Tynan MJ (1987) The value of counter-current aortography in infants.Int J Cardiol 15:333–339
Scott PJ, Wharton GA, Gibbs JL (1990) Failure of Doppler ultrasound to detect coarctation of the aorta.Int J Cardiol 28:379–381
Smallhorn JF, Huhta JC, Adams PA, Anderson RH, Wilkinson JL, Macartney FJ (1983) Cross-sectional echocardiographic assessment of coarctation in the sick neonate and infant.Br Heart J 50:349–361
Stanger P, Heymann MA, Tarnoff H, Hoffman JIE, Rudolph AM (1974) Complications of cardiac catheterisation of neonates, infants and children.Circulation 50:595–608
Ueda K, Saito A, Nakano H (1982) Aortography by countercurrent injection via the radial artery in infants with congenital heart disease.Pediatr Cardiol 2:231–236
Wilson N, Sutherland GR, Gibbs JL, Dickinson JF, Keaton BR (1989) Limitations of Doppler ultrasound in the diagnosis of neonatal coarctation of the aorta.Int J Cardiol 23:87–89
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Anjos, R., Kakadekar, A., Murdoch, I. et al. Countercurrent aortography: An alternative to cardiac catheterization in infancy. Pediatr Cardiol 13, 10–13 (1992). https://doi.org/10.1007/BF00788222
Issue Date:
DOI: https://doi.org/10.1007/BF00788222