P.H. Heintzen – författare

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.