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Posts Tagged ‘krichenko classification of pda’

PDA is a common congenital heart disease.It results in progressive left to right shunting.

Development of pulmonary hypertension is the major complication.PDA need to be closed once the diagnosis is made.Until recently surgery was the only option.Now we have device, coil closure   available. Not all ducts are amenable to device closure.

For a duct to be closed by device we have to know the exact anatomy of the ductus.echocardiography has  limitation to  accurately image the ductus. Angiogram is the specific method.

What is  the normal length of patent ductus  arteriosus ?

The length of duct is very variable it can vary between 1 mm to 35  mm.

A 2 mm PDA is nothing but direct adherence of aorta and pulmonary artery (Ultra short form , similar to AP window )

pda-size-ductus

What is the branching angle of ductus from aorta and the entry angle at the pulmonary artery ?

This is an important determinant of technical success of device closure .Very abtuse or acute angled ductus can

face difficulty in deploying devices. The normal angle in lateral view is between 30-60 d

How do you classify PDA ? .

There is only one classification of PDA available  based on angiogram .Krichenko*

pda-4

pda-2

pda-31

Taken from  *Krichenko A,. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol. 1989; 63: 877–879

Review article on PDA

http://www.circ.ahajournals.org/cgi/content/full/114/17/1873

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