All issues > Volume 35(5); 1992

Original Article

J Korean Pediatr Soc. 1992;35(5):602-606. Published online May 15, 1992.

Color Doppler Echocardiographic Evaluation of Residual Ductal Flow After Surgical Ligation

I Seok IS Kang¹, Hyun H Kwack¹, Chung Il CI Noh¹, Jung Yun JY Choi¹, Yong Soo YS Yun¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Abstract

We evaluated the incidence of residual ductal flow with color Doppler echocardiography and associated clinical findings in 63 patients who had undergone surgical ligation for isolated PDA, The interval between surgery and color Doppler echocardiographic evaluation ranged from 2 days to6.6 years(mean 7 months). In 40 patients, color Doppler echocardiographic studies were done within 1month after surgery. In 8 of 63 patients (12%), color Doppler echocardiography revealed typical ductal flow into the main pulmonary artery. Of 8 patients with residual ductal flow, a continuous murmur thpical of ductal patency was found in only a patient. Three patients had grade 2/6 short systolic murmur at pulmonary area. One patient had apical systolic murmur due to secondary mitral regurgitation and three patients had no detectable mumur. Of 55 patients with no residual shunting, six patients had short systolic murmur at pulmonary area. No association between age at surgery, surgical technique, PDA size and residual shunt could be identified. In 2 cases, the residual ductal flow disappeared on later color Doppler echocardiographic examination. During follow-up infective arteritis was not noted in any patients with residual shunt. These results revealed that auscultatory findings are unreliable in indentifying residual ductal flow. The clinical significance of residual flow detected by color Doppler examination and the necessity for antibiotic prophylaxis against infective endocarditis in these patients remain uncertain and need further evaluation.

Keywords :Residual ductal flow, PDA ligation, Color Doppler echocardiography