Patent ductus arteriosus size estimation by echocardiography and angiography: A comparative study

PDA Size estimation

Abstract

Background: Patent ductus arteriosus (PDA) is the common congenital heart disease that needs medical attention to deal with disease related complications. With the advancement of transcatheter intervention closure of PDA by coil or Amplatzer devices, has become acceptable alternate to surgical ligation.

Objects: The study was aimed estimation of size of patent ductus arteriosus by 2D and colour Doppler echocardiography and to compared with the data obtained by angiography.

Methods: This retrospective study was conducted during January 2014 to December 2016 and data were collected from records of Paediatric Cardiology Department of BSMMU. Fifty children were included in the study. All the cases were assessed with 2D echocardiography, color doppler echocardiography (CDE) and angiography and underwent device closure. Estimation of PDA size were done with 2D, color doppler and angoigraphically and were compared and analysed statistically.

Results: Out of 50 cases, ages ranged from 10 months to 28 years with a mean age of 5.75 ± 5.33 years. The mean weight was 16.3 ± 10.58 Kg with a range of 5.5 Kg to 54 kg and sex distribution was 16 males and 34 females. Visualization of the patent ductus arteriosus was achieved from short-axis and suprasternal-axis views in all children with CDE. The mean diameter of pulmonary end of patent ductus arteriosus was 3.45 ± 0.96 millimetre with a range from 1.45 to 6.20 millimetres in CDE. The mean diameter of aortic end of PDA 4.64±1.30 with a range of 2.50 to 9.50 in 2D and CDE respectively. The mean angiographic measurement of aortic end of PDA was 5.35±1.42 with a range of 2.60 to 10. Both 2D echo and CDE correlated significantly (p value <.0.001) with angiographic measurement at both pulmonary and aortic ends. The Pearson correlation coefficient for 2D echo and CDE are 0.967 and 0.973 respectively at pulmonary end indicating that CDE correlates marginally better than 2D echo with angiographic measurements at the pulmonary end. Similarly at the aortic end (ampulla), the Pearson correlation coefficient for 2D echo and CDE are 0.955 and 0.966 respectively indicating that both correlates with angiography but CDE is better correlates. 

Conclusion: It may concluded that it is almost always possible to measure the dimensions of the patent ductus arteriosus with colour doppler echocardiography, keeping in mind that color doppler echocardiographic measurement overestimates the angiographic measurement of the pulmonary side of the patent ductus arteriosus and underestimates its aortic side.

Bangladesh Med Res Counc Bull 2019; 45: 11-16