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PH.H. QUANJER 4.2 Selected SI prefixes Factor Prefix 106 mega 1()3 kilo 102 hecto lQI deca w-• deci lQ-2 centi lQ-3 milli lQ-

SUMMARYThe circulatory status of four patients with anomalous systemic-pulmonary circulations has been studied by bronchospirometry, cardiac catheterization, angiography, and dyedilution techniques. In three of these patients the affected lung was smaller than normal, and bronchography showed no abnormalities. On the affected side angiography failed to show filling of the pulmonary artery, and the oxygen uptake appeared to be zero or minimal. In two of the patients bronchospirometry revealed an effective collateral circulation, whereas the dye-dilution curves were almost normal. In the other patient there was anatomic evidence of both transpleural systemic-pulmonary arterial communication and occlusive disease of the pulmonary veins. Here the dye-dilution curves revealed considerable shunting of blood, whereas no effective collateral circulation could be demonstrated. The fourth patient has extensive unilateral bronchiectasis and illustrates the condition wherein neither pulmonary nor systemic blood flows through the pulmonary capillary bed.The pathogenesis of the various pathways of collateral circulation is discussed, as well as some methodological and technical problems. ADDITIONAL INDEXING WORDS:Bronchopulmonary circulation Obstruction of pulmonary veins Bronochospirometry IN RECENT YEARS the number of reports on anomalous systemic-pulmonary circulation has steadily increased, and several aspects of anatomic and functional pathology have been studied.'-6 Anomalous communications between bronchial and pulmonary circulation have been described in organizing pulmonary disease,6-1" congenital atresia, or acquired obliteration of the pulmonary artery.12-5 As not only bronchial vessels, but also other systemic arteries may be involved,16 17 the diagnostic label has been appropriately changed from collateral bronchopulmonary circulation to collateral systemic-pulmonary circulation.