Hemodynamically Significant Patent Ducts Arteriosus: Impact of Ductal Size on Left Output and Aortic Doppler Velocimetry

Abstract

Children with patent ductus arteriosus (PDA) present with several degrees of hemodynamic states. It is not known if there is any link between ductal size and hemodynamic states. This study elicited the prevalence of hemodynamically significant PDA (hsPDA) and attempted to document the impact of ductal size on left output and aortic Doppler velocimetry. This is a cross-sectional study that assessed the prevalence of hsPDA and the relationship of ductal size and parameters of left ventricular function (LVF) in children and adolescents aged 3–19 years. The mean left ventricular mass (LVM) for respondents with PDA, 8.3 ± 5.3, was lower than that of the control, 14.3 ± 5.2, and the mean difference was found to be statistically significant (Mann–Whitney U = 7.270, p < 0.001). The prevalence of small, moderate, and large hsPDA was 40.7%, 35.6%, and 23.7% respectively. The commonest age of presentation of hsPDA is 1 month of age. There was a weak negative correlation between PDA size and ejection fraction (EF), increases in PDA size correlate with decreases in EF, but this was not found to be statistically significant (n = 59, r = − 0.233, p = 0.076). There was a weak positive correlation between PDA size and velocity, increases in PDA size correlate with increases in velocity, and this was not found to be statistically significant (n = 43, r = 0.252, p = 0.104). The prevalence of hsPDA in this study was high. The LVM in healthy children and adolescents was higher than in those with PDA. Left ventricular mass in children with PDA correlates inversely with descending aorta velocity.