J A Wong1, D Shim, P R Khoury, R A Meyer. 1. Division of Cardiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Abstract
BACKGROUND: Echocardiography is sometimes performed to identify candidates for coil embolization of patent ductus arteriosus (PDA). Therefore we attempted to determine the validity of color Doppler echocardiography to accurately determine the minimum PDA diameter. METHODS AND RESULTS: We reviewed data from 27 children (median 3.8 years, range 1 to 15 years) with PDAs and measured their minimum ductal diameters by color flow Doppler echocardiography and by angiography. We found that there were significant mean differences between the color Doppler and angiographic measurements (2.7+/-0.8 vs 1.6+/-0.7 mm, P< .001) with color Doppler exceeding angiographic measurements by > or = 1.0 mm in 15 (56%) of 27 patients. More importantly, color Doppler measured a PDA > or = 4.0 mm (usually greater than that recommended for coiling) in 3 (11%) patients in whom the angiographic measurement was <4.0 mm. Correlation analysis demonstrated no correlation between the color Doppler and angiographic measurements (r2 = 0.17, P= .04, SEE = 0.2 mm). CONCLUSIONS: These data suggest that color Doppler echocardiography often overestimates the true minimum PDA diameter, therefore we recommend that a color Doppler-based recommendation that a PDA is too large for transcatheter coil occlusion not be used exclusively to exclude a patient from this treatment modality.
BACKGROUND: Echocardiography is sometimes performed to identify candidates for coil embolization of patent ductus arteriosus (PDA). Therefore we attempted to determine the validity of color Doppler echocardiography to accurately determine the minimum PDA diameter. METHODS AND RESULTS: We reviewed data from 27 children (median 3.8 years, range 1 to 15 years) with PDAs and measured their minimum ductal diameters by color flow Doppler echocardiography and by angiography. We found that there were significant mean differences between the color Doppler and angiographic measurements (2.7+/-0.8 vs 1.6+/-0.7 mm, P< .001) with color Doppler exceeding angiographic measurements by > or = 1.0 mm in 15 (56%) of 27 patients. More importantly, color Doppler measured a PDA > or = 4.0 mm (usually greater than that recommended for coiling) in 3 (11%) patients in whom the angiographic measurement was <4.0 mm. Correlation analysis demonstrated no correlation between the color Doppler and angiographic measurements (r2 = 0.17, P= .04, SEE = 0.2 mm). CONCLUSIONS: These data suggest that color Doppler echocardiography often overestimates the true minimum PDA diameter, therefore we recommend that a color Doppler-based recommendation that a PDA is too large for transcatheter coil occlusion not be used exclusively to exclude a patient from this treatment modality.