Abstract
Echocardiography assessment of L-R ductal shunting has relied on indirect estimates of flow ie. left atrial, and left ventricular to aortic ratios (LA:Ao, LVEDD:Ao). Since left ventricular output (LVO) increases with L-R ductal shunting it could provide an alternative means of assessment. Measurement by echocardiography is innaccurate due to error in measurement of aortic root cross-sectional area (AoCSA). Doppler measurement of the aortic flow integral or ‘stroke distance’ (AoSD) is highly reproducible. LVO -AoCSA × AoSD × heart rate, therefore, AoSD & minute distance (MinDis=AoSD × heart rate) were evaluated as alternative methods, excluding AoCSA. Studies before and after ductal constriction or closure were compared in babies <32 weeks gestation. 48 courses of indomethacin (indo) were needed in 39 babies. 8 babies, in whom indo failed, were assessed prior to ligation. Results were also compared with 107 scans from 53 babies, aged <28 days. & <32 weeks with a closed duct*.
Conclusion: Aortic stroke & minute distance can be used to assess ductal shunting & can be usefully combined with other methods. Significant shunting is likely when AoSD >12cm or MinDis > 1900cm.
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Skinner, J., Hunter, S. & Hey, E. AORTIC STROKE & MINUTE DISTANCE: A NEW WAY TO ASSESS DUCTAL SHUNTING. Pediatr Res 32, 614 (1992). https://doi.org/10.1203/00006450-199211000-00054
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DOI: https://doi.org/10.1203/00006450-199211000-00054
