What is the role of cardiac catheterization and angiography in the diagnosis of patent ductus arteriosus (PDA)?

Updated: Nov 20, 2018
  • Author: Luke K Kim, MD; Chief Editor: Stuart Berger, MD  more...
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Cardiac catheterization and angiography is not indicated for the uncomplicated patent ductus arteriosus (PDA). Color-flow Doppler mapping is more sensitive than cardiac catheterization in detecting a small patent ductus arteriosus (PDA). However, cardiac catheterization may be required for confirmation of clinical diagnosis in children with pulmonary hypertension and/or associated congenital cardiovascular malformations; response to pulmonary vasodilators can be important in planning operative intervention.

Cardiac catheterization may be used as a therapeutic procedure for coil embolization/occluder and to demonstrate the following:

  • The shunt

  • The amount of the shunt

  • The pulmonary pressure

  • Other coexisting cardiac abnormalities

During right heart catheterization, the measured oxygen saturation is increased in the pulmonary artery, except in Eisenmenger syndrome. The shunt (Qp/Qs) and the pulmonary vascular resistance (PVR) can be calculated to determine the size of the ductus and the presence of pulmonary vascular pathology.

Selective angiography is the definitive tool for determining the presence and size of the ductus. Angiography is also used to define the intracardiac anatomy when other defects are suspected.

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