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Theoretical approach to discrimination of atrial and ventricular septal defects when the left-to-right cardiac shunt is diagnosed by radionuclide angiography

Detection and quantification of left-to-right (L-R) cardiac shunt using radiotracers provides a non-traumatic diagnostic method. Maltz and Treves (Circulation, vol.47, p.1049-56, 1973) have proposed a 'gamma variate' technique for analysing the pulmonary time-activity curve in order to obtain the ratio of pulmonary to systemic flow that shows whether the shunt exists or not. The method, according to Maltz and Treves, offers the quantification of shunt but fails to discriminate between the atrial and the ventricular septal defect. In the present theoretical study the authors show how one might deduce, from analysis of the right heart and pulmonary time-activity curves, whether the existing L-R shunt is caused by atrial or ventricular septal defect. To the best of the authors' knowledge such a possibility has not yet been proposed as a radiotracer diagnostic method.

black box analysis ; radio tracers ; deconvolution

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