No abstract available.
Diagnosis ; Ductus Arteriosus, Patent ; Endarteritis ; Pulmonary Embolism

No abstract available.
Diagnosis* ; Ductus Arteriosus, Patent* ; Echocardiography, Doppler, Pulsed* ; Sensitivity and Specificity*

No abstract available.
Diagnosis ; Ductus Arteriosus, Patent ; Humans ; Infant, Newborn ; Infant, Premature

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus (PDA) that should be treated is difficult to determine by clinical and echocardiographic examination. The purpose of this study is to clarify the usefulness of diastolic flow velocity (DFV) of the left pulmonary artery (LPA) determined by echocardiography in the assessment of significant PDA in preterm infants. METHODS: Clinical and echocardiographic findings, including DFV in LPA, of PDA were evaluated at 24 hours, 48-72 hours of age and after indomethacin treatment in thirty-nine infants ranging from 25 to 34 gestational weeks of age. DFVs of the study group (N=13) with significant PDA were compared with those of healthy control group (N=26) without significant PDA. RESULTS: DFVs in healthy preterm infants were high in the first few days and were significantly decreased after spontaneous ductal closure. DFVs in preterm infants with significant PDA who underwent indomethacin treatment were significantly higher than that of healthy control infants. After indomethacin treatment, DFVs in this study group remained high with continuing significant PDA and markedly decreased with disappearance of significant PDA. Until ductus arteriosus closed, DFVs showed a significant correlation with the magnitudes of ductal shunt. A cutoff value for DFV of 30 cm/sec showed a sensitivity of 77% and a specificity of 92% as a predictor of significnat PDA in preterm infants. CONCLUSION: Measurement of DFV in LPA by echocardiography is a useful method for assessing the significnat PDA which may require treatment in preterm infants.
Diagnosis* ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Pulmonary Artery* ; Sensitivity and Specificity

PURPOSE: Patent ductus arteriosus (PDA) of prematurity is very important disease to study because it causes many cases of perinatal morbidity and its incidence is now increasing. Nowadays indomethacin is the drug of choice for PDA closure, but its use has been limited due to its side effects. Therefore, we compared the effect and side effects of indomethacin according to the infusion method, continuous versus intermittent infusion, to find better an administration method. METHODS: Twenty-five preterm infants who were admitted to Seoul National University Children's Hospital (SNUCH) NICU from March 1995 to August 1996 with a diagnosis of respiratory distress syndrome (RDS) and PDA, were enrolled. They were randomly assigned to intertmittent lV group or continuous lV group. Each group received three intermittent doses or continuous infusion over 36 hours, respectively. We analyzed the perinatal history, time of diagnosis and treatment of PDA, size of PDA, and compared the laboratory parameters, intraventricular hemorrhage (IVH), periventricular echogenecity (PVE), ductal closure and perinatal morbidity before and 48 hours after indomethacin administration between the two groups. RESULTS: Fourteen infants (birth weight 1,149 +/- 373g) were intermittent lV group and eleven infants (birth weight 1,212 +/- 504g) were continuous lV group. There were no significant difference between the groups in perinatal history, pretreatment laboratory parameters, ductal closure, and perinatal morbidity. Patients with IVH of grade 2 or more increased significantly in intermittent lV group (50%) compared to continuous lV group (9%), and PVE progressed significantly in intermittent lV group (64%) compared to continuous lV group (18%). CONCLUSION: Continuous infusion of indomethacin for PDA closure in preterm infants with RDS appears to be as effective as intermittent infusion of indomethacin in closing PDA and have less side effects such as IVH and PVE progress.
Diagnosis ; Ductus Arteriosus, Patent ; Hemorrhage ; Humans ; Incidence ; Indomethacin* ; Infant ; Infant, Newborn ; Infant, Premature* ; Seoul

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus(PDA) that should be treated is difficult to determine by clinical and echocardiographic examinations. The aim of this study was to clarify the interrelationship of plasma atrial natriuretic peptide(ANP) concentrations and clinical signs or echocardiographic signs of PDA in preterm infants and use plasma ANP concentrations as a diagnostic indicator of a hemodynamically significant PDA. METHODS: Twenty-four preterm infants who were born at Guro Hospital, Korea Medical Center were evaluated on the 3rd day after birth. Clinical signs(cardiovascular dysfunction score 3) and echocardiographic signs[magnitude of left-to-right shunt across a PDA and left atrium(LA): Ao ratio] of a PDA and plasma ANP concentrations were measured. RESULTS: Plasma ANP concentrations and LA/Ao ratios of preterm infants with hemodynamically significant PDA were significantly higher than those of preterm infants without hemodynamically significant PDA. Plasma ANP concentrations were related to the magnitude of the left- to-right shunt across a PDA and LA: Ao ratio. Plasma ANP concentrations of LA/Ao of more than 1.3 were significantly higher than that of LA/Ao of less than 1.3. CONCLUSION: In preterm infants, high plasma ANP concentration may be a useful predictive indicator of a hemodynarnically significant PDA. Measurement of plasma ANP concentration may play a role in deciding the need for and timing of medical or surgical management of preterm infants with PDA.
Atrial Natriuretic Factor ; Diagnosis* ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Infant, Newborn ; Infant, Premature* ; Korea ; Parturition ; Plasma

Correlation between electrocardiographic findings and hemodynamics in 108 children with patent ductus arteriosus, confirmed by cardic catheterization at SNUH, was evaluated. The results were as follows: 1. Age at diagnosis: patients(75/108) were before 10 years old, but about one third of patients(33/108) were over 10 years old. 2. Sex distribution: M:F=1:2 3. Correlation between ventricular hypertrophy pattern by ECG and mean pulmonary arterial pressure: RVH : 57.2mmHg CVH : 42.6mmHg LVH : 25.6mmHg Normal : 20.4mmHg 4. Tall R, deep Q and peaked T in V6 were observed in 5.9% of the cases, tall R and deep Q in 14.7%, tall R and peaked T in 8.8%, tall R only in 41.2% and normal R in 29.4%. By increasing the Qp/Qs ratio, the more cases showed the left ventricular diastolic overloading pattern by Cabrera.
Arterial Pressure ; Catheterization ; Catheters ; Child* ; Diagnosis ; Ductus Arteriosus, Patent ; Electrocardiography* ; Hemodynamics* ; Humans ; Hypertrophy ; Sex Distribution

PURPOSE: Patent ductus arteriosus (PDA) of prematurity is very important disease to study because it causes many cases of perinatal morbidity and its incidence is now increasing. Nowadays indomethacin is the drug of choice for PDA closure, but its use has been limited due to its side effects. Therefore, we compared the effect and side effects of indomethacin according to the infusion method, continuous versus intermittent infusion, to find better an administration method. METHODS: Twenty-five preterm infants who were admitted to Seoul National University Children's Hospital (SNUCH) NICU from March 1995 to August 1996 with a diagnosis of respiratory distress syndrome (RDS) and PDA, were enrolled. They were randomly assigned to intertmittent lV group or continuous lV group. Each group received three intermittent doses or continuous infusion over 36 hours, respectively. We analyzed the perinatal history, time of diagnosis and treatment of PDA, size of PDA, and compared the laboratory parameters, intraventricular hemorrhage (IVH), periventricular echogenecity (PVE), ductal closure and perinatal morbidity before and 48 hours after indomethacin administration between the two groups. RESULTS: Fourteen infants (birth weight 1,149 +/- 373g) were intermittent lV group and eleven infants (birth weight 1,212 +/- 504g) were continuous lV group. There were no significant difference between the groups in perinatal history, pretreatment laboratory parameters, ductal closure, and perinatal morbidity. Patients with IVH of grade 2 or more increased significantly in intermittent lV group (50%) compared to continuous lV group (9%), and PVE progressed significantly in intermittent lV group (64%) compared to continuous lV group (18%). CONCLUSION: Continuous infusion of indomethacin for PDA closure in preterm infants with RDS appears to be as effective as intermittent infusion of indomethacin in closing PDA and have less side effects such as IVH and PVE progress.
Diagnosis ; Ductus Arteriosus, Patent ; Hemorrhage ; Humans ; Incidence ; Indomethacin* ; Infant ; Infant, Newborn ; Infant, Premature* ; Seoul

BACKGROUND AND OBJECTIVES: Patent ductus arteriosus (PDA) is associated with increased morbidity and mortality in premature infants. Therefore, an early diagnosis and treatment of a hemodynamically significant PDA are very important. A widened pulse pressure is considered to be a well known clinical sign of a PDA in older infants and children; however, whether this is also applicable in the case of preterm infants remains to be confirmed. The aims of this study were to investigate the change in blood pressure (BP) before and after medical treatment of a PDA with indomethacin and to evaluate if the change in the pulse pressure in preterm infants with a medically treated PDA could be used as a reliable clinical predictor of a hemodynamically significant PDA. SUBJECTS AND METHODS: Between January 2005 and June 2009, a retrospective analysis was performed in preterm infants with a hemodynamically significant PDA (PDA group, n=72) and preterm infants without a PDA (control group, n=72) at the Chonnam National University Hospital Neonatal Intensive Care Unit. The PDA was closed by treatment with indomethacin. The BP was compared between the two groups over the seven days after the first dose of indomethacin. RESULTS: In preterm infants with a hemodynamically significant PDA, the mean systolic (55.1+/-6.0 mmHg) and diastolic BPs (31.4+/-6.2 mmHg) were lower than those in the controls (mean systolic BP 58.0+/-6.4 mmHg, mean diastolic BP 34.7+/-6.0 mmHg) before indomethacin treatment. When the ductus arteriosus was successfully closed by indomethacin treatment, there was a gradual increase in both the systolic and diastolic BPs without any change in the pulse pressure. CONCLUSION: The results of this study show that a widened pulse pressure is not a useful clinical sign of a hemodynamically significant PDA in preterm infants. However, low systolic and diastolic BPs may be useful clinical signs of a hemodynamically significant PDA in preterm infants. If the systolic and diastolic BP is low, a PDA should be considered and echocardiography should be performed for early diagnosis and treatment.
Blood Pressure ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Early Diagnosis ; Echocardiography ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Retrospective Studies

Aneurysmal dilatation of the ductus arteriosis has been considered a rare but potentially fatal abnormality. The mechanism of ductal aneurysmal formation remains uncertain. Plain chest radiography has proven helpful in the diagnosis of ductus arteriosus aneurysm (DAA), before the application of transthoracic echocardiography. The transthoracic echocardiography is an important tool for the diagnosis and follow-up of DAA. We present a case of congenital ductus arteriosus aneurysm in a newborn, that was an incidental discovery. The diagnosis was made by echocardiography, three-dimensional surface rendering computed tomography (CT), and spontaneous regression after four weeks of follow-up.
Aneurysm* ; Diagnosis ; Dilatation ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Echocardiography ; Echocardiography, Three-Dimensional ; Follow-Up Studies ; Humans ; Incidental Findings ; Infant, Newborn ; Radiography ; Thorax