THE RELATIVE VALUE OF INVASIVE TECHNIQUES IN CARDIOLOGICAL DIAGNOSIS

The inauguration of invasive methods in the clinical cardiology has en abled a subtle qualitative and quantitative diagnostic of anomalies of the heart and great vessels first in childhood and thereafter in infa ncy and in the neonatal period. The optimizing of the diagnostic tools was accompanied by the development of methods for operations. Since t hen echocardiography was developed, which for the first time was not s uited for the diagnostic in children. After important technical improv ements now echocardiography (inclusively doppler echocardiography) has become a method by which nearly all heart diseases can by diagnosed n on-invasively and safe without the risk of the invasive methods. In th e meanwhile echocardiography has reduced indications and applications of invasive methods in all age groups, especially in the neonatal peri od. In patients with inoperable malformations of the heart we can give up invasive diagnostic measures which are accompanied with high risk especially in these children. Even more helpful and definite diagnosti c evidence is given by the MR-tomography. But this method requires mor e technical expense and the access is limited. Nevertheless there rema in some malformations of the heart and great vessels, in which invasiv e diagnostic measures are necessary praeoperatively and even postopera tively. Moreover interventional cardiology has become a new indication for the invasive access.