open access

Vol 79, No 3 (2020)
Original article
Submitted: 2019-05-05
Accepted: 2019-10-04
Published online: 2019-10-29
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Detailed radiological study of the patent ductus arteriosus: a computed tomography study in the Polish population

M. Krupiński1, M. Irzyk1, Z. Moczulski1, R. Banyś1, M. Kuniewicz2, M. Urbańczyk-Zawadzka1
·
Pubmed: 31688948
·
Folia Morphol 2020;79(3):462-468.
Affiliations
  1. Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
  2. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 79, No 3 (2020)
ORIGINAL ARTICLES
Submitted: 2019-05-05
Accepted: 2019-10-04
Published online: 2019-10-29

Abstract

Background: The aim of the study was to perform qualitative and quantitative computed tomography (CT) angiography-based evaluation of patent ductus arteriosus (PDA) morphology and its influence on morphology of the great vessels.

Materials and methods: Two-thousand twenty-two patients underwent 64-slice or dual-source CT and were retrospectively screened for the presence of PDA. Those who had presence of PDA underwent evaluation of its anatomy and morphology.

Results: Thirty-two adult patients with PDA were evaluated (mean age 41.4 ± 17.4 years). Subjects with PDA had a higher value of aortic isthmus (p = 0.0148), main pulmonary artery (p < 0.0001), right (p =0.0007) and left (p = 0.0074) pulmonary arteries diameters than individuals from control group (16 adults, median age 43.3 ± 12.4 years). Types A, B, C, D, and E of PDA morphology occurred in 16 (50%), 3 (9%), 9 (28%), 2 (6%), and 2 (6%) patients, respectively. Subjects with the type A configuration of PDA tended to have a larger diameter at the aortic orifice (10.2 ± 5.2 mm vs. 6.4 ± 4.9 mm, p = 0.09) and a larger maximal diameter (10.3 ± 5.3 mm vs. 7.1 ± 4.7 mm, p = 0.14) compared to subjects with the type C configuration. The values of minimal, mean, and maximal diameters of PDA were 4.7 ± 1.9 mm, 7.0 ± 3.2 mm, and 9.4 ± 5.0 mm, respectively. The Spearman correlation coefficient between the main pulmonary artery and PDA diameters demonstrated a good correlation for minimal (r = 0.70, p < 0.001), mean (r = 0.62, p = 001), and maximal (r = 0.60, p = 0.0003) PDA diameters.

Conclusions: Computed tomography enables quantitative and qualitative evaluation of PDA, including its type of morphology, length, and diameters. In the evaluated adult population with PDA, the majority of patients had dilation of the aortic isthmus and pulmonary arteries. PDA diameters correlate with diameters of the pulmonary arteries and this correlation is strongest between PDA diameter at the narrowest site and main pulmonary artery.

Abstract

Background: The aim of the study was to perform qualitative and quantitative computed tomography (CT) angiography-based evaluation of patent ductus arteriosus (PDA) morphology and its influence on morphology of the great vessels.

Materials and methods: Two-thousand twenty-two patients underwent 64-slice or dual-source CT and were retrospectively screened for the presence of PDA. Those who had presence of PDA underwent evaluation of its anatomy and morphology.

Results: Thirty-two adult patients with PDA were evaluated (mean age 41.4 ± 17.4 years). Subjects with PDA had a higher value of aortic isthmus (p = 0.0148), main pulmonary artery (p < 0.0001), right (p =0.0007) and left (p = 0.0074) pulmonary arteries diameters than individuals from control group (16 adults, median age 43.3 ± 12.4 years). Types A, B, C, D, and E of PDA morphology occurred in 16 (50%), 3 (9%), 9 (28%), 2 (6%), and 2 (6%) patients, respectively. Subjects with the type A configuration of PDA tended to have a larger diameter at the aortic orifice (10.2 ± 5.2 mm vs. 6.4 ± 4.9 mm, p = 0.09) and a larger maximal diameter (10.3 ± 5.3 mm vs. 7.1 ± 4.7 mm, p = 0.14) compared to subjects with the type C configuration. The values of minimal, mean, and maximal diameters of PDA were 4.7 ± 1.9 mm, 7.0 ± 3.2 mm, and 9.4 ± 5.0 mm, respectively. The Spearman correlation coefficient between the main pulmonary artery and PDA diameters demonstrated a good correlation for minimal (r = 0.70, p < 0.001), mean (r = 0.62, p = 001), and maximal (r = 0.60, p = 0.0003) PDA diameters.

Conclusions: Computed tomography enables quantitative and qualitative evaluation of PDA, including its type of morphology, length, and diameters. In the evaluated adult population with PDA, the majority of patients had dilation of the aortic isthmus and pulmonary arteries. PDA diameters correlate with diameters of the pulmonary arteries and this correlation is strongest between PDA diameter at the narrowest site and main pulmonary artery.

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Keywords

multi-slice computed tomography; patent ductus arteriosus; cardiovascular abnormalities

About this article
Title

Detailed radiological study of the patent ductus arteriosus: a computed tomography study in the Polish population

Journal

Folia Morphologica

Issue

Vol 79, No 3 (2020)

Article type

Original article

Pages

462-468

Published online

2019-10-29

Page views

1027

Article views/downloads

1703

DOI

10.5603/FM.a2019.0116

Pubmed

31688948

Bibliographic record

Folia Morphol 2020;79(3):462-468.

Keywords

multi-slice computed tomography
patent ductus arteriosus
cardiovascular abnormalities

Authors

M. Krupiński
M. Irzyk
Z. Moczulski
R. Banyś
M. Kuniewicz
M. Urbańczyk-Zawadzka

References (19)
  1. Backer CL, Mavroudis C. Congenital heart surgery nomenclature and database project: patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch. Ann Thorac Surg. 2000; 69(4 Suppl): S298–S307.
  2. Beerbaum P, Körperich H, Barth P, et al. Noninvasive quantification of left-to-right shunt in pediatric patients: phase-contrast cine magnetic resonance imaging compared with invasive oximetry. Circulation. 2001; 103(20): 2476–2482.
  3. Carlgren LE. The incidence of congenital heart disease in children born in Gothenburg 1941-1950. Br Heart J. 1959; 21(1): 40–50.
  4. El Hajjar M, Vaksmann G, Rakza T, et al. Severity of the ductal shunt: a comparison of different markers. Arch Dis Child Fetal Neonatal Ed. 2005; 90(5): F419–F422.
  5. Espino-Vela J, Cardenas N, Cruz R. Patent ductus arteriosus. With special reference to patients with pulmonary hypertension. Circulation. 1968; 38(1 Suppl): 45–60.
  6. Evans N, Iyer P. Assessment of ductus arteriosus shunt in preterm infants supported by mechanical ventilation: effect of interatrial shunting. J Pediatr. 1994; 125(5 Pt 1): 778–785.
  7. Forsey JT, Elmasry OA, Martin RP. Patent arterial duct. Orphanet J Rare Dis. 2009; 4: 17.
  8. Goitein O, Fuhrman CR, Lacomis JM. Incidental finding on MDCT of patent ductus arteriosus: use of CT and MRI to assess clinical importance. AJR Am J Roentgenol. 2005; 184(6): 1924–1931.
  9. Kim JH, Baek JH. Thoracic endovascular repair technique for the treatment of patent ductus arteriosus in an elderly patient: A case report. Medicine (Baltimore). 2018; 97(49): e13558.
  10. Kimura-Hayama ET, Meléndez G, Mendizábal AL, et al. Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 2010; 30(1): 79–98.
  11. Krichenko A, Benson LN, Burrows P, et al. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol. 1989; 63(12): 877–880.
  12. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971; 43(3): 323–332.
  13. Pelberg R, Mazur W. Vascular CT Angiography Manual. Springer-Verlag, London 2003.
  14. Schneider D, Moore J. Patent ductus arteriosus. Circulation. 2006; 114(17): 1873–1882.
  15. Shimada S, Kasai T, Konishi M, et al. Effects of patent ductus arteriosus on left ventricular output and organ blood flows in preterm infants with respiratory distress syndrome treated with surfactant. J Pediatr. 1994; 125(2): 270–277.
  16. Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 139(14): e637–e697.
  17. Suzmura H, Nitta A, Tanaka O. Diastolic flow velocity of left pulmonary artery of patent ductus arteriosus in preterm infants. Pediatr Int. 2001; 43: 146–151.
  18. Waller BF. Morphological aspects of valvular heart disease: Part I. Curr Probl Cardiol. 1984; 9(7): 1–66.
  19. Walther FJ, Kim DH, Ebrahimi M, et al. Pulsed Doppler measurement of left ventricular output as early predictor of symptomatic patent ductus arteriosus in very preterm infants. Biol Neonate. 1989; 56(3): 121–128.

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