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Echocardiographic findings of hemodynamically significant patent ductus arteriosus (PDA) in preterm neonates

Echocardiographic findings of hemodynamically significant patent ductus arteriosus (PDA) in preterm neonates
Echocardiographic finding
PDA diameter:
  • Moderate size: 1 to 1.5 mm × √BSA or PDA:LPA ratio ≥0.5 to 1
  • Large: >1.5 mm × √BSA or PDA:LPA ratio ≥1
Diastolic flow reversal in the abdominal aorta
Unrestrictive flow across the PDA:
  • Ao-PDA flow velocity <2 m/s, or
  • Mean pressure gradient ≤8 mmHg across the PDA
LA enlargement not otherwise explained
LV enlargement not otherwise explained
LA hypertension (estimated qualitatively by septal bowing from LA to RA or quantitatively by flow velocity across PFO)
This table summarizes echocardiographic findings that suggest a large and hemodynamically significant PDA in preterm neonates. The assessment is typically based upon multiple findings rather than a single isolated finding. Clinical findings (eg, respiratory support requirement) should also be considered when determining if a PDA is hemodynamically significant. Refer to UpToDate topics on PDA in preterm infants for additional details.
PDA: patent ductus arteriosus; BSA: body surface area; LPA: left pulmonary artery; Ao: aorta; LA: left atrium; LV: left ventricle; RA: right atrium; PFO: patent foramen ovale.
Graphic 141537 Version 1.0

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