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Angiocardiography has undergone tremendous development. It
currently repre- sents the imaging system offering the highest
resolution and greatest detail information. A widely applicable,
complex technique able to meet high standards was required by the
increasing number of coronary bypass interventions as well as by
the advent of interventional catheter techniques, such as
transluminal per- cutaneous catheter balloon dilatation,
recanalization techniques, and intracoro- nary thrombolytic
procedures. At the same time, improved image resolution began to
furnish information on intracoronary flow dynamics and anatomy,
thereby opening a new avenue of acquiring prognostically and
therapeutically important pathophysiologic information. In spite of
rapid improvements in the equipment, there are still demands for
improved resolution, image quality, and methods of image
processing. In this situation, the need was felt to describe the
current status of equipment, angiocardiographic systems, image
intensifiers, photographic materials, and processing techniques.
Furthermore, the attempt was made to describe evalua- tion
techniques using manual or computer-assisted semi- or fully
automated procedures to estimate left ventricular volumes,
ventricular mass, cardiac func- tion, anatomy, and flow dynamics of
the coronary arterial system. This book assembles original work
presented at a symposium held by the European Soci- ety of
Cardiology, the Deutsche Gesellschaft fur Herz-und
Kreisiaufforschung, and the Deutsche Gesellschaft fUr
Biomedizinische Technik. It was the aim of the symposium to outline
the current state of the art and to define a process for further
improvement.
According to Schopenhauer problems are usually passing through
three stages: - in the first stage they are ignored or just smiled
at, - in the second stage they are fought, and in the third stage
they are considered to be self-evident, just taken for granted.
Whereas digital subtraction angiography (DSA) has obviously reached
stage three of that scale, i.e. routine use in radiology, digital
angiocardiography, in particular imaging the heart and coronary
circulation, is still on its way to the final goal: the filmless
heart catheterization laboratory for all invasive and
interventional procedures. A few pioneers have already completely
abandoned the conventional cine coronary and angiocardiographic
technique, others - as we do -still combine both digital and
conventional methods in clinical routine, but most cardiol ogists
up till now stay sceptically aside. We hope that at least some of
the articles published in this volume may convince more and more
cardiologists that digital imaging procedures are the method of
choice, in particular if quantitative assessment of the anatomical
or functional status of the cardiovascular system is required (pre-
and post operations or pre-and post-interventions). Such a critical
control of all therapeutic procedures, be it by surgical,
catheter-or medical 'interventions', is indeed an urgent and widely
under estimated or neglected requirement."
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