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Echocardiographic evaluation, management and outcomes of bilateral arterial ducts and complex congenital heart disease: 16 years' experience

Published online by Cambridge University Press:  15 August 2006

Alejandro Peirone
Affiliation:
The Hospital for Sick Children and the University of Toronto, Toronto, Canada
Mustafa M. Abdullah
Affiliation:
The Hospital for Sick Children and the University of Toronto, Toronto, Canada
Frank Dicke
Affiliation:
Division of Cardiology, Children's Hospital of Western Ontario and the University of Western Ontario, London
Robert M. Freedom
Affiliation:
Head, Division of Cardiology, The Hospital for Sick Children and Professor of Paediatrics and Pathology, University of Toronto, Toronto, Canada
Jeffrey Smallhorn
Affiliation:
Echocardiography Laboratory, The Hospital for Sick Children and Professor of Paediatrics, University of Toronto, Toronto, Canada

Abstract

Bilateral arterial ducts represent an uncommon form of pulmonary or systemic blood supply associated with complex congenital cardiac disease. We sought to determine the role of high-resolution cross-sectional echocardiography and color flow Doppler ultrasonography in assessing this condition, as well as to describe the management and outcome in a group of patients. A retrospective review was conducted of 11 newborns identified over a 16-year period as having bilateral arterial ducts. Pulmonary atresia associated with non-confluent pulmonary arteries was the dominant lesion, with the heterotaxy syndrome also frequently being recognized. Echocardiography best identified the source of blood supply to either the pulmonary or systemic circulations, allowing differentiation from collateral vessels. Stenosis of the right or left pulmonary artery at the initial site of ductal insertion needs careful evaluation on follow-up. Management of patients with this condition remains a challenge, as indicated by the poor outcomes observed in our series.

Type
Original Article
Copyright
2002 Cambridge University Press

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