Author(s): Ravi Srinivas1, Yerrabandi Venkata Subba Reddy2, Adikesava Naidu Otikunta3
PDA device closure is an important nonsurgical method of treatment. Device size estimation depends upon the accurate assessment of the morphology and size of the PDA. Although, angiography is the gold standard for estimation of the size of the PDA, 2D echo and colour Doppler are comparable noninvasive alternatives. Put together, the three modalities are useful in fairly accurate estimation of the PDA size and prevention of complications like device embolisation or incomplete ductal closure. The purpose of this study is to compare PDA measurements made by 2D echo and colour Doppler with those made by angiography in the cardiac catheterisation laboratory.
MATERIALS AND METHODS
15 cases of PDA referred to Osmania General Hospital between August 2013 and August 2016 were included in the study. All the cases were assessed with 2D echo, colour Doppler and angiography and underwent device closure. PDA size estimated by 2D echo colour Doppler and angiography were compared and statistically analysed.
The patient ages ranged from 5 yrs. to 32 yrs. with a mean age of 14±8.5 yrs. There were 10 females and 5 males. As regards the type of PDA, all of them belonged to the A type based on Krichenko’s classification. The mean diameter of pulmonary end measured 6.1±2.56 mm by 2D echo, 5.03±1.9 mm by colour Doppler, 5.32±2.17 mm by angiography. The mean diameter of aortic end measured 9.4±2.3 mm by 2D echo, 8.1±2.19 mm by colour Doppler, 8.4±2.29 mm by angiography. Both 2D echo and colour Doppler measurements correlated significantly with angiographic measurements at both pulmonary and aortic ends. The Pearson correlation coefficient for 2D echo and colour Doppler are 0.927 and 0.977 respectively at the pulmonary end indicating that CDE correlates marginally better than 2D echo with angiographic measurements at the pulmonary end. However, a larger sample size is needed to prove this. At the aortic end (ampulla), the Pearson correlation coefficient for 2D echo and colour Doppler are 0.896 and 0.969 respectively indicating that CDE correlates with angiography better than 2D echo.
The M:F ratio in the present study. The commonest type of the ductus in the present study is the type A based on Krichenko’s 1 classification. Both 2D echo and colour Doppler correlated significantly with angiographic estimation of PDA size, but colour Doppler correlated slightly better than 2D echo. A larger sample size is needed to prove the same. Measurement of the aortic end of the ductus with colour Doppler when compared to pulmonary end correlated more significantly with angiography than 2D echo.