Echo Rounds
Anesthesia & Analgesia: Volume 105, Issue 5, Page 1227.
"Incidental Discovery of a Large Patent Ductus Arteriosus in an Adult During Aortic Reconstruction: Echocardiographic Findings and Diagnostic Dilemmas" by Neuman et al.
Data Files:
- Echo Loop
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One video containing 6 Clips
Clip 1:
Baseline 4-chamber view.
Clip 2:
Upper esophageal aortic arch short axis view of the dissected aorta. The aorta is in short axis with a true and false lumen; the enlarged main pulmonary artery in long axis. There is a high velocity color flow jet from the border of the true and false lumen to the main PA. The color jet is aliasing at a Nyquist limit of 55cm/s and the zoomed color jet shows a small PISA hemisphere.
Clip 3:
Same view as in clip 2, now with injection of agitated saline into the right atrial port of the pulmonary artery catheter. Neither negative nor positive contrast can be seen.
Clip 4:
Same view as in clip 2 & 3, now enlarged to focus on the aliasing color jet.
Clip 5:
High pulse repetition frequency Doppler of the aorto-pulmonary connection shows a left to right gradient of 16mmHg (Bernoulli equation; Gradient = 4 x (2m/s)2 ).
Clip 6:
The resected specimen shows true and false lumens of the aorta. The large PDA traverses both lumens but ultimately leaves the false lumen to enter the main pulmonary artery.
UE: upper esophageal, SAX: short axis, PA: pulmonary artery, PDA: patent ductus arteriosus
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