Quantification of left-to-right shunt through patent ductus arteriosus by colour Doppler in children admitted for a device closure.
نویسنده
چکیده
PURPOSE Our animal model suggests that quantification of ductal flow from colour Doppler pixels is possible. We aimed to clarify whether this method can be used to determine a clinically significant ductal shunt in children. METHODS We retrospectively quantified ductal flow from saved images from 20 children who had been admitted for device occlusion of patent ductus arteriosus. Colour Doppler images over the main stem of the pulmonary artery were obtained in longitudinal cross-sections. The colour pixel percentages during diastole, representing ductal flow, were correlated with the documented shunt, measured invasively according to Fick's principle. RESULTS The ratio of pulmonary to systemic flow correlated best with the sum of the percentages of green colour pixels (r = 0.73, r2 = 0.54, p < 0.001). When the shunt was 1.5:1 or more, 12 out of 13 infants had 50% or more of the region of interest covered with green pixels--sensitivity 92%, specificity 71%. The correlation between ductal diameter and pulmonary-to-systemic flow ratio was less significant (r = 0.6, r2 = 0.37, p < 0.03). CONCLUSIONS We conclude that clinically significant shunts with pulmonary-to-systemic flow ratio over 1.5 can be diagnosed with this method where neither the size of the patient nor echocardiographic settings seem to be critical. The method could be used to provide an objective indication for ductal closure, but further prospective studies in children are needed to verify the power of the method.
منابع مشابه
Quantification of left-to-right shunt through Patent Ductus Arteriosus by colour Doppler Clinical and experimental studies
متن کامل
Evaluating the Clinical Course of Patent Ductus Arteriosus after Discharge and Comparing in Therapies Techniques
Background Patent ductus arteriosus is an open channel between the aorta and pulmonary artery. The study aimed to evaluate the clinical course of patent ductus arteriosus after discharge and comparing in therapies technique. Materials and Methods This cross-sectional and inferential- descriptive study was performed in the hospitals of city of Zahedan-Iran in the period of one decade from 2005 ...
متن کاملNoninvasive Doppler echocardiographic evaluation of shunt flow dynamics of the ductus arteriosus.
The pulsed Doppler technique was used to record the flow velocity patterns in the ductus arteriosus and the pulmonary artery in 26 patients with either isolated or complicated patent ductus arteriosus (PDA). In all patients, abnormal Doppler signals indicating left-to-right (L-R) or right-to-left shunt flow or both could be obtained at the site of the ductus arteriosus. These Doppler flow patte...
متن کاملLigation of patent ductus arteriosus in the very low birthweight newborn infant.
Surgical closure of a patent ductus arteriosus was performed in 8 low birthweight infants suffering from cardiorespiratory failure secondary to a large left-to-right shunt. Mortality from the operation was nil, but only 4 (50%) ultimately survived. Earlier intervention may reduce mortality in these high-risk infants.
متن کاملEchocardiographic assessment of patent ductus arteriosus shunt flow pattern in premature infants.
AIMS To identify the patent ductus arteriosus (PDA) shunt flow pattern using Doppler echocardiography; and to assess whether it could be used to predict the development of clinically significant PDA. METHODS Premature infants weighing under 1500 g, who required mechanical ventilation, and in whom daily echocardiography could be performed from day 1 until the ductus closed, and on day 7 to con...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Cardiology in the young
دوره 23 2 شماره
صفحات -
تاریخ انتشار 2012