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PubMed1999

Echocardiographic diagnosis of thrombus originating from the ductus arteriosus.

Initial functional closure of the ductus arteriosus normally occurs within hours after birth, with permanent closure taking several weeks. The mechanism for ductal closure has been well studied and has not been shown to include thrombus formation. We describe a normal infant found to have a thrombus originating in the ductus arteriosus that occluded the ductus and subsequently extended into the left pulmonary artery, threatening to occlude it as well. This case illustrates the importance of echocardiography in making this rare diagnosis. It also emphasizes the role of echocardiography as an effective means of following the progression or regression of such a thrombus.

Anticoagulants↗
PubMed1991

Percutaneous balloon exploration and plug closure of ductus arteriosus.

Percutaneous closure of ductus arteriosus (DA), preceded by a balloon exploration of the defect and a catheter scale examination of the foam plug, was performed on 47 patients aged from 6 to 54 years. The minimal internal diameter of DA varied from 3.7 to 11.6 mm. Successful occlusion was achieved in all the cases without major complications. Sustained improvement was observed in both clinical findings and laboratory parameters. No incidence of endocarditis, plug displacement or recanalization was noted during follow-up of 6 to 35 months. It revealed that ductal exploration with the balloon catheter is able to ascertain the actual occlusion diameter of the lesion and the catheter scale plug examination can ensure good matching between DA and the plug so that changing of plugs and ectopic embolisms can be avoided.

Adolescent↗
PubMed2005

Initial clinical experience of real-time three-dimensional echocardiography in neonates with isolated congenital ductus arteriosus aneurysm.

BACKGROUND: Congenital ductus arteriosus aneurysm (DAA) was considered rare but potentially fatal abnormality, often followed by surgical intervention after careful evaluation. This prospective study used real-time three-dimensional echocardiography (RT3DE) to assist in evaluation of neonatal DAA. METHODS: A total of 1390 full-term neonates were enrolled in this study between 2002 and 2003. They received two-dimensional echocardiographic (2DE) screening and periodic follow-up. RT3DE was performed selectively for newborns with DAA. RESULTS: DAA were detected in 116 (8.34%) newborns using 2DE. Maximum diameter of the DAAs ranged from 6.8 to 14.0 mm (8.2+/-1.1 mm). None of the cases were symptomatic or had complications related to DAA. There were no significant differences in sex and gestational age between the newborns with and without DAA. Neonates with DAA had a higher birth body weight and a higher incidence of large-for-gestational-age (P<0.05). RT3DE provided instant, consistent and reliable 3D images of DAA and its related structures and allowed for more rapid examination times and reduction of baby wait times. CONCLUSIONS: Congenital DAA is as common as has been previously reported. RT3DE is useful in assisting evaluation of DAA. Preferred images of DAA were typically visualized in the high parasternal short-axis view before the third day of life. Routine use of RT3DE is suggested to enhance assessment of neonates with DAA detected by 2DE.

Ductus Arteriosus↗
PubMed1988

Congenital absence of ductus arteriosus--an autopsy case.

Isolated absence of the ductus arteriosus is extremely rare condition although the ductus arteriosus may be hypoplastic or aplastic in association with other aortic arch anomalies. Authors described a case of isolated agenesis of the ductus arteriosus documented by postmortem examination of a newborn infant who died of pneumonia following operation for a large omphalocele. The heart showed ventricular septal defect. However, no other cardiovascular anomalies were associated in this case. There were three vessels that were taking off from the aorta consisted of the right brachiocephalic artery, left common carotid-artery and left subclavian artery. The anteriorly located pulmonary artery was divided into the right and left pulmonary arteries. There was no connection of vessel between the pulmonary artery and the aorta.

Abnormalities, Multiple↗
PubMed1996

Prenatal ultrasonographic assessment of the ductus arteriosus: a review.

OBJECTIVE: To review current data pertaining to prenatal ultrasonography of the ductus arteriosus. DATA SOURCES: We reviewed manuscripts published in the English language regarding prenatal ultrasonography and the fetal ductus arteriosus obtained from a MEDLINE search for 1966 onward. Additional sources were identified through cross-referencing. METHODS OF STUDY SELECTION: Data regarding morphology, physiology, pathophysiology of fetal disease, and hemodynamic changes after administration of various maternal medications and structural congenital anomalies of the ductus arteriosus were selected. DATA EXTRACTION AND SYNTHESIS: Knowledge of the function of the ductus arteriosus in both normal and abnormal fetal conditions is enhanced by prenatal ultrasonographic findings. Detailed analyses of ductus arteriosus hemodynamics are indicated in well-defined medical conditions, including maternal medication and established structural or functional fetal cardiac disease. CONCLUSION: The fetal ductus arteriosus is a vascular structure of major functional importance. Knowledge of physiologic hemodynamic changes of blood flow in this vessel obtained by prenatal ultrasonography in conjunction with increasing gestational age, maternal medication, fetal growth restriction, as well as the detection of structural anomalies, may assist in clinical management of complicated pregnancies.

Ductus Arteriosus↗
PubMed2005

Patent ductus arteriosus, indomethacin and necrotizing enterocolitis in very low birth weight infants: a population-based study.

BACKGROUND: Patent ductus arteriosus is a risk factor for the development of necrotizing enterocolitis. The use of indomethacin to treat patent ductus arteriosus in preterm infants may either decrease the incidence of necrotizing enterocolitis by stabilizing or closing the ductus arteriosus or increase its incidence by a direct constricting effect on mesenteric blood vessels. The authors sought to evaluate the interrelationship between patent ductus arteriosus, treatment with indomethacin and the risk of necrotizing enterocolitis in very low birth weight infants. METHOD: The Israel National database includes prospectively collected data on 99% of all very low birth weight infants in Israel. The study population comprised 6146 infants of 24-34 weeks' gestation born between 1995 and 2000. The effect of patent ductus arteriosus on necrotizing enterocolitis was assessed using multiple regression analysis. RESULTS: Necrotizing enterocolitis occurred in 5.5% (n = 343) of all infants, in 9.4% of infants with patent ductus arteriosus and in 8.9% of infants who received indomethacin. The occurrence of necrotizing enterocolitis was independently associated with the presence of patent ductus arteriosus among infants not treated with indomethacin (odds ratio, 1.85) and those who received indomethacin therapy (odds ratio, 1.53). Indomethacin therapy in absence of patent ductus arteriosus was not associated with an increased risk of necrotizing enterocolitis (odds ratio, 0.72). CONCLUSIONS: Patent ductus arteriosus is an independent risk factor for the development of necrotizing enterocolitis in very low birth weight infants. Therapy with indomethacin did not have a significant effect on the risk for necrotizing enterocolitis.

Cardiovascular Agents↗
PubMed1980

Development of the ductus arteriosus in right ventricular outflow tract obstruction.

We studied the morphology of the ductus arteriosus in 14 infants, ages 2--90 days. Eight (group 1) had pulmonary atresia (structural and functional) with an intact interventricular septum; six (group 2) had pulmonary atresia with a ventricular septal defect. The inferior angle of the ductus arteriosus at the aortic junction was measured in each patient. In group 1, this angle was obtuse in all but one patient. In group 2, the angle was acute in all. Further study of intracardiac anatomy suggested that in group 1, the obtuse inferior angle of the ductus arteriosus was the result of a late and progressive obstructive phenomenon that allowed normal right-to-left flow through the ductus arteriosus during much of fetal life. In group 2, the direction of ductus arteriosus flow (normally from the pulmonary trunk to the aorta) was reversed, and flowed from the aorta to the pulmonary trunk. This reversal of flow was probably of early onset in the fetus, the aorta receiving the total combined ventricular output, and produced a small ductus arteriosus with an acute inferior angle. It is extremely important not to rule out pulmonary atresia with an intact interventricular septum when aortography in the newborn shows a normal-sized ductus arteriosus with an obtuse inferior angle. Despite existing pulmonary atresia, these patients have neither a hypoplastic right ventricle nor discontinuity of the right ventricle with the pulmonary artery.

Ductus Arteriosus↗
PubMed1988

A morphological study on the obliteration processes of the ductus arteriosus in the horse.

The obliteration processes of the ductus arteriosus of equine foetuses and newborn foals were studied morphometrically and histologically. The length, internal and external diameters and circumference of the ductus in equine foetuses increased progressively and linearly up to 310 days with advancing foetal age, but the values, especially the internal diameter, decreased from 320 to 330 days. After birth, the ductal measurements decreased gradually and ductal closure was found in three of 14 foals examined on the first day post partum, in two of six on the second day and in nine of nine on the third day or later, suggesting that the ductus arteriosus closes physiologically within three days after birth. Microscopical findings of the ductus arteriosus were characterised by the rearrangement of smooth muscle cells in the inner media and intimal thickening in foetuses, and by the central displacement of the intima in newborn foals. It was concluded that the ductus arteriosus begins to undergo preparatory modifications during intrauterine life, when the vessel is still functional, and that the most significant starting point of change in the obliteration processes is the rearrangement of smooth muscle cells in the inner media, which occurs during pre- and post natal life.

Animals↗
PubMed2003

[Case report: 3D CT angiography in a patient with patent ductus arteriosus associated with Eisenmenger's syndrome].

Presentation of patent ductus arteriosus with Eisenmenger's syndrome can mimic primary pulmonary hypertension. The sensitivity of transthoracic echocardiography for the diagnosis of patent ductus arteriosus with Eisenmenger's syndrome has been estimated as low as 12%. Transesophageal echocardiography is superior to transthoracic echocardiography for the diagnosis of patent ductus arteriosus but has some severe complications. 3D CT angiography can be used to distinguish patent ductus arteriosus with Eisenmenger's syndrome from primary pulmonary hypertension.

Diagnosis, Differential↗
PubMedDate not supplied

Ligation in adult persistent ductus arteriosus.

Seventy one patients with a persistent ductus arteriosus were operated upon at the Cardiovascular Unit in Gülhane Military Medical Academy. The mean age of these cases was 24 years. Twenty five patients (35%) were asymptomatic. The average pulmonary artery systolic pressure was 50 +/- 22 mmHg. In the majority of the cases the ductus was ligated (91.5%), but 6 of the cases were treated by division (8.5%). Early and late complications or mortality were not encountered. In this study 71 cases are reviewed: the preoperative cardiac catheterization and the operative findings are studied in relation to the surgical procedures used. Ligation is a simple, quick and effective surgical treatment for persistent ductus arteriosus in adults.

Adult↗
PubMed2005

Operation for adult patent ductus arteriosus using an aortic stent-graft technique.

Patent ductus arteriosus is a condition usually diagnosed and treated in childhood but in some instances is not detected until adult life. Although surgical closure remains the accepted treatment in most cases, stent-grafting has emerged as a possible alternative treatment for persistent ductus arteriosus in the adult. We describe a case of elective repair of a patent ductus arteriosus using an aortic stent-graft technique in a young man. Successful use of the endoprosthetic approach may allow more widespread use of this technique in adult patent ductus arteriosus.

Adult↗
PubMed2000

[Aneurysm of the ductus arteriosus Botalli].

A congenital aneurysm of the ductus arteriosus Botalli was detected by chest X-ray as an intrathoracic mass in a 7-day-old infant. Following confirmation of the diagnosis by echocardiography and MRI the aneurysm was successfully resected via left lateral thoracotomy without cardiopulmonary bypass. The postoperative course was uneventful. Six years after operation the patient is asymptomatic and growing normally. An intrathoracic mass may be considered in the differential diagnosis especially in infants and children. Aneurysms of ductus arteriosus potentially are associated with serious complications. Timely diagnosis and early surgical intervention are decisive for prevention of serious complication and death.

Aneurysm↗
PubMed2001

The use of renal Doppler ultrasonography to diagnose patent ductus arteriosus in preterm infants.

OBJECTIVE: To prospectively study the diagnostic usefulness of altered renal waveforms in patent ductus arteriosus. METHODS: We studied preterm infants undergoing echocardiography for a suspected patent ductus arteriosus. A spectral Doppler display was acquired for both renal arteries, and a resistive index was obtained. Sensitivity, specificity, and likelihood ratios were calculated using a clinically significant patent ductus arteriosus (>1.5-mm diameter on color Doppler ultrasonography) as the standard of reference. RESULTS: Fifty infants had 78 scans. A significant patent ductus arteriosus was present on 39 scans. When the renal resistive index was greater than 1.0, the likelihood ratio for a significant patent ductus arteriosus was 24.8 (specificity, 97.2%; SD, 3.8%). When the renal resistive index was 1.0 or less, the likelihood ratio for a significant patent ductus arteriosus was 0.2 (sensitivity, 77.2%; SD, 9.4%). CONCLUSIONS: Renal resistive index measurement is a simple investigation that can predict a significant patent ductus arteriosus in patients without congenital heart disease or other causes of diastolic runoff when echocardiography is unavailable.

Ductus Arteriosus, Patent↗
PubMed1993

[Echocardiographic study on the anatomy and blood flow pattern of ductus arteriosus in normal fetus].

The anatomy and blood flow pattern of ductus arteriosus in fetus were studied by echocardiogram in 51 pregnant women. According to the duration of pregnancy, women were divided into 3 groups: group A (15-24 weeks) 15 cases; group B (25-34 weeks) 23 cases; and group C (35-41 weeks) 13 cases. The mean blood flow velocity in ductus arteriosus was 88.8 cm/sec in group A, 112.7 cm/sec in group B, and 130.4 cm/sec in group C (P < 0.0001), and they were significantly higher than that in aorta and pulmonary artery (P < 0.001). The characteristics of Doppler blood flow pattern was higher peak velocity in systolic and lower in diastolic. The ratio of diameter of right pulmonary artery to ductus arteriosus was 1:1. To recognize the characteristic blood flow pattern is a reliable sign to identify ductus arteriosus in fetus, and reference data of ductus arteriosus blood flow was presented.

Blood Flow Velocity↗