Role of Radionuclide Shunt Studies in Management of Infants and Children

The utility of radionuclide-shunt quantitation in children was assessed by examination of the outcome of 128 patients who underwent shunt study over a two-year period. The possibility of cardiac catheterization was eliminated in 87. Fifty of these had undergone previous cardiac catheterizations, which suggested the necessity for further invasive study or surgery; after radionuclide evaluation, 28 were shown to have had enough spontaneous closure of the defect to cancel planned surgery, 12 were scheduled for surgery without repeat catheterization, and ten had nuclear rather than catheterization estimates of residual shunting following surgical repair of septal defects. Thus, radionuclide shunt study provides a relatively noninvasive technique to quantitate left-to-right shunts, supplementing or supplanting cardiac catheterization in the management of infants and children with such lesions.