Left-sided contrast echocardiography with hydrogen peroxide — Comparative effectiveness of pulmonary wedge injection by use of Swan-Ganz catheter and Cournand catheter

Abstract

Pulmonary wedge injection of hydrogen peroxide is a new, safe, effective and reliable method for left-sided contrast echocardiography. For examination, Cournand or Swan-Ganz catheter was inserted into the pulmonary wedge position. Normal saline was injected first to clear out blood from the wedge-shaped region, subsequently followed by 0.5–1.5 ml of 3 % hydrogen peroxide, then another injection of normal saline was given to push hydrogen peroxide through the pulmonary capillary network. Out of 64 patients with various heart diseases, after injection of hydrogen peroxide, 57 showed contrast echoes in the left heart system. The success rate of left-sided contrast echocardiography was 89.1%. Some patients with left-to-right shunt showed contrast echoes in the left and right heart systems simultaneously. In Cournand catheter group (24 cases), success rate of left-sided contrast was 83.3% and sensitivity for detecting left-to-right shunt was 23.5%. But in Swan-Ganz catheter group (40 cases), success rate and sensitivity were 92.5% and 94.1% respectively. This means that the method with Swan-Ganz catheter shows higher success rate and better practical value for the diagnosis of acyanotic congenital heart disease. No untoward reactions were noted in any of the patients with the exception of short burst of coughing in 5 cases.

Keywords

hydrogen peroxide / contrast echocardiography / pulmonary wedge injection / Swan-Ganz catheter / Cournand catheter

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