Pediatric Cardiology

, Volume 2, Issue 4, pp 271–275 | Cite as

Precordial contrast echocardiographic detection of patent ductus arteriosus in small preterm infants

  • Mirka Zednikova
  • Barry G. Baylen
  • Yoshiro Yoshida
  • George C. Emmanouilides


Clinical detection of patent ductus arterious (PDA) remains an important and challenging problem in the small preterm infant with respiratory distress. In this study, PDA was diagnosed in 28 small preterms using an improved contrast echocardiographic method. In these infants, the injection of saline into the aorta generated echoes which were imaged at the pulmonary valve. This was accomplished using a conventional M-mode ultrasound transducer applied at the usual precordial position. Contrast echo studies were compared with the degree of ductal patency shown by single film aortography. Ductal patency was detected by contrast echo in 29 of 31 instances of aortographically proven PDA.

Indirect echo indices commonly used for detection of PDA (cardiac chamber enlargement) may be limited since factors other than left-to-right shunt can cause cardiac enlargement in distressed small preterms. This direct contrast echo technique is an easily performed, sensitive, qualitative method for confirmation of the diagnosis of PDA in small preterm infants.

Key words

Patent ductus arteriosus Contrast echocardiography 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allen HD, Sahn DJ, Goldberg HJ: New serial contrast technique for assessment of left-to-right shunting patent ductus arteriosus in the neonate.Am J Cardiol 41:288–294, 1978PubMedCrossRefGoogle Scholar
  2. 2.
    Baylen BG, Emmanouilides GC: Patent ductus arteriosus in the newborn. In (Gregory GA, Thibeault DW, eds.)Neonatal Pulmonary Care. Menlo Park, Addison-Wesley, 1979, p 318Google Scholar
  3. 3.
    Baylen BG, Meyer RA, Kaplan S, Ringenburg WE, Korfhagen J: The critically ill premature infant with patent ductus arteriosus and pulmonary disease: An echocardiographic assessment.J Pediatr 86:423–432, 1975PubMedCrossRefGoogle Scholar
  4. 4.
    Baylen BG, Meyer RA, Korfhagen J, Benzing G, Bubb ME, Kaplan S: Left ventricular performance in the critically ill premature infant with patent ductus arteriosus and pulmonary disease.Circulation 55:182–188, 1977PubMedGoogle Scholar
  5. 5.
    Dubowitz LMS, Dubowitz V, Goldberg C: Clinical assessment of gestational age in the newborn infant.J Pediatr 77:1–10, 1970PubMedCrossRefGoogle Scholar
  6. 6.
    Gramiak R, Shah PM, Kramer DH: Ultrasound cardiography contrast studies in anatomy and function.Radiology 92:939–942, 1969PubMedGoogle Scholar
  7. 7.
    Higgins CB, DiSessa T, Kirkpatrick SE, Ching CT, Edwards DK, Friedman WF, Kelly MJ, Kurlinski J: Assessment of patent ductus arteriosus in preterm infants by single lateral film aortography.Radiology 135:641–647, 1980PubMedGoogle Scholar
  8. 8.
    Hirschklau MJ, DiSessa TG, Higgins CB, Friedman WF: Echocardiographic diagnosis: Pitfalls in the premature infant with a large patent duct arteriosus.J Pediatr 92:474–477, 1980Google Scholar
  9. 9.
    Jacob J, Gluck L, DiSessa T, Edwards D, Kulovich M, Kurlinski J, Merrit TA, Friedman WF: The contribution of PDA in the neonate with severe RDS.J Pediatr 96:79–87, 1980PubMedCrossRefGoogle Scholar
  10. 10.
    Johnson GL, Nirmala SD, Cottrill CM, Johnson M, Noonan JA: Echocardiographic systolic time intervals in premature infants with patent ductus arteriosus.Ped Cardiol 1:103–107, 1980CrossRefGoogle Scholar
  11. 11.
    McGrath RL, McGuinnes GA, Way GL: The silent ductus arteriosus.J Pediatr 93:110–113, 1978PubMedGoogle Scholar
  12. 12.
    Meyer RA:Pediatric Echocardiography, Philadelphia, Lea and Febiger, 1976, p 70Google Scholar
  13. 13.
    Silverman NH, Lewis AB, Heymann MA, Rudolph AM: Echocardiographic assessment in ductus arteriosus shunt in premature infants.Circulation 50:821–825, 1974PubMedGoogle Scholar
  14. 14.
    Spach MS, Serwer GA, Anderson PAW, Canent RV Jr, Levin AR: Pulsatile aortography pressure-flow dynamics of patent ductus arteriosus in patients with various hemodynamic states.Circulation 61:110–122, 1980PubMedGoogle Scholar
  15. 15.
    Stevenson GJ, Kawabori I, Guntheroth WG: Non-invasive detection of pulmonary hypertension in patent ductus arteriosus by pulsed doppler echocardiography.Circulation 60:355–359, 1980Google Scholar
  16. 16.
    Thibeault DW, Emmanouilides GC, Nelson RJ, Lachman RS, Rosengart RM, Oh W: Patent ductus arteriosus complicating the respiratory distress syndrome in premature infants.J Pediatr 86:120–126, 1975PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1982

Authors and Affiliations

  • Mirka Zednikova
    • 1
  • Barry G. Baylen
    • 1
  • Yoshiro Yoshida
    • 1
  • George C. Emmanouilides
    • 1
  1. 1.The Department of Pediatrics, Division of CardiologyUniversity of California at Los Angeles, Harbor-UCLA Medical CenterUSA

Personalised recommendations