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Objectives:To find a noninvasive metho d to detect coarctation of the aorta(CoA)in the presence of a patent ductus ar teriosus(PDA)in neonates.Study design:From 1994 to 1998,36 neonates with Co A and PDA confirmed by surgery or cardiac catheterization were studied;another 19 neonates with isolated PDA served as control patients.The prospective study was conducted from 2001 to 2002 on 162 neonates.Results:Among the 36 neonates in the CoA group,14 patients(39%)had blood pressure discrepancy,26 patients(72%)had a visualized posterior shelf by echocardiogram,and the ratio of ist hmus/descending aorta diameters(I/D ratio)was below 0.64 in 32 patients(89%).None of the control patients had these features.A diagnostic approach was sub sequently proposed,according to which a neonate with PDA who fulfilled any of t he above features was diagnosed as CoA plus PDA.In the prospective study,the s ensitivity and positive predictive values of this method were both 91.7%,where as the specificity and negative predictive values were both 99.3%.Conclusions:Echocardiographic measurements of I/D ratio along with the delineation of poste rior shelf and a BP discrepancy can satisfactorily identify CoA in the presence of PDA in neonates.
Objectives: To find a noninvasive metho d to detect coarctation of the aorta (CoA) in the presence of a patent ductus ar osiosus (PDA) in neonates. Study design: From 1994 to 1998, 36 neonates with Co A and PDA confirmed by surgery The prospective study was conducted from 2001 to 2002 on 162 neonates. Results: Among the 36 neonates in the CoA group, 14 patients (39%) had blood pressure Of the 26 patients (72%) had a visualized posterior shelf by echocardiogram, and the ratio of ist hmus / descending aorta diameters (I / D ratio) was below 0.64 in 32 patients (89%). features.A diagnostic approach was sub-solved, according to which a neonate with PDA who fulfilled any of t above features was diagnosed as CoA plus PDA. the prospective study, the ensurance and positive predictive values of this method were both 91.7 %, where as the specificity and ne Conexlusions: Echocardiographic measurements of I / D ratio along with the delineation of poste rior shelf and a BP discrepancy can satisfactorily identify CoA in the presence of PDA in neonates.