Retrograde brachial aortography; its use in the diagnosis of patent ductus arteriosus and coarctation of the aorta in infancy.

Patent ductus arteriosus and coarctation of the aorta are among the commonest causes of congestive heart failure early in life. When medical therapy fails to control heart failure in these cases, surgical division of the ductus or excision of the coarcted segment can be performed. But the recognition of these anomalies in infancy is more difficult than in childhood or adult life. Retrograde thoracic aortography is a technique which permits positive identification. In the presence of patent ductus arteriosus, opacification of the pulmonary arteries from the descending aorta will be clearly shown; if coarctation is present, its position, severity, and the length of the involved segment can usually be demonstrated. Properly employed, retrograde brachial aortography is a relatively safe and effective diagnostic procedure.