穂積 元³, 平石 聰², 古木 量一郎¹, 鶴野 和則¹

Hajime HOTSUMI³, Satoshi HIRAISHI², Ryoichiro FURUKI¹, Kazunori TSURUNO¹

¹北里大学病院臨床検査部, ²北里大学病院小児科, ³本多記念東北循環器科病院

¹Department of Clinical Laboratory, Kitasato University Hospital, ²Department of Pediatrics, Kitasato University Hospital, ³Honda Memorial Tohoku Cardio-Vascular Medical Center

キーワード : Congenital heart disease, Patent ductus arteriosus, Echocardiography

High-parasternal cross-sectional echocardiographic technique was used to visualize the ductus arterious (DA) in 25 neonates and infants with various congenital heart diseases (CHD). Our method ennabled to image the DA along its entire length from the pulmonary to aortic ends. Abnormal Doppler signals indicating left-to-right or bidirectional shunt was obtained at the site of DA in all patiens with pulsed Doppler technique. The configuration of the DA was divided into two types by which the inferior angle between the DA and the descending aorta was acute (Type II) or obtuse (Type I). The DA appeared to be cylindrical in patients with Type I and tortuous in patient with Type II. The latter type of the DA was seen in the patients with tricuspid atresia, pulmonary atresia and severe pulmonary valve stenosis with or without ventricular septal defect. Futhermore in 11 patients, we observed the morphological changes of the DA in the course of the spontaneous closure using two-dimensional Doppler echocardiography. Irrespective of types of the DA, closure of the DA began to localizedly narrow at the sites of the pulmonary end or in the middle portion within the DA, and subsequently, ductal narrowing progressed along the entire length.