Objectives: Patent ductus arteriosus (PDA) is a relatively frequent finding in destressed newborns, especially premature infants. It’s importance is due to hemodynamic changes that take place in the systemic circulation, influencing cardiac output, and in cerebral blood flow due to blood steal at the level of the patent ductus. This can rise the risc of brain injury among infants with hemodynamically significant left to right shunting. Our goal was to evaluate transfonatnellar eco-Doppler appearance in these babies, interpreating measurements from the clinical point of view.
Materials and methods: We measured by transfontanellar ultrasonography the eco-Doppler parameters of cerebral blood flow (CBF) at the level of the Anterior Cerebral Artery (ACA) in 15 prematures with demonstrated haemodynamically significant ductus arteriosus, and compared the resuslts with normal values for the age measured in 30 healthy prematures with the same gestational age.
Results: We found in all infants with semnificative left to right shunt at the level of the PDA low levels of end-diastolic velocities, even negative values in 4 cases due to blood steal in the PDA. Later clinical symptoms showed a direct corelation with the grade of left-to-right shunt and cerebral cahnges.
Conclusions: Our results demonstrate the importance of monitoring the effects of PDA on CBF in the indication for medical or surgical closure of the ductus arteriosus, due to the correlation between the severity of the PDA and decrease of CBF, transfontanellar Doppler assessment being a usefull tool in centers where echocardiography is not available.