A new method for determining intracardiac shunts in patients with congenital heart disease by means of analog computer simulation of radiocardiogram, precordial radioisotope-dilution curve, is described. The whole circulatory system was represented by a closed loop of four compartments; that is, the right heart, lung, left heart and body, which were approximated by first order systems with or withour transport lags. Mathematical equations describing the transportation processes of the injected radioisotope in these four compartments, taking intracardiac shunts into consideration, were given and an analog simulation circuit of radiocardiogram was composed. The values of pulmonary blood flow, systemic blood flow and %L-R shunt in 28 patients with congenital heart disease (ASD : 21, VSD : 3, PDA : 4) obtained by the analog computer simulation of radiocardiogram were in good agreement with those obtained by the Fick method, the correlation coefficient being 0.922, 0.814 and 0.942, respectively. Pulmonary blood volume in these patients was shown to increase in proportion to the pulmonary blood flow (r=0.749, N=87, p<0.001). Considering the safety and simplicity of the technique, this method is advantageous in quantitative diagnosis of congenital heart disease.
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