[Aortic flow patterns in normal neonates with patent ductus arteriosus: evaluation by Doppler color flow imaging]

Serial Doppler echocardiography was performed in 12 normal neonates (0.5-4.0 hrs after birth) to evaluate flow patterns through the ductus arteriosus, and in the aorta and brachiocephalic artery. At the initial examination, flow through the ductus arteriosus was bidirectional in eight of the 12 neonates and continuously left-to-right in the remaining four. The bidirectional ductal shunts became continuous left-to-right flows within 11-21 hrs after birth in seven of the eight neonates and resolved by 29-47 hrs after birth. In the remaining four neonates, the continuous left-to-right shunts disappeared 14-36 hrs after birth. Systolic ejection flow patterns in the aorta and brachiocephalic artery had a triangular shape with the peak velocity in early systole, followed by a minimal flow reversal in all sites examined. Diastolic flow patterns in each arterial site were as follows: 1. In the ascending aorta, there was slow and sustained diastolic forward flow, which did not change with increasing age. 2. In the brachiocephalic artery, there was a pan-diastolic flow reversal in the neonates with bidirectional ductal flow (7/8). This pattern changed to slow pan-diastolic forward flow when the ductal changed to continuous left-to-right flow or when the ductal closure was confirmed. Most (3/4) of the remaining four neonates with continuous left-to-right ductal flow exhibited pan-diastolic forward flow. Another showed a pan-diastolic flow reversal 2 hrs after birth, which changed to pan-diastolic forward flow in the second examination 6 hrs after birth. 3. In the distal aortic arch, there was a pan-diastolic forward flow in all the neonates, and the velocity decreased when a closure of the ductus was confirmed. 4. In the descending aorta, there was a pan-diastolic flow reversal in neonates with bidirectional ductal flow (7/8). This reversal changed to pan-diastolic forward flow, when the ductal flow changed to continuous left-to-right flow or when the ductal closure was confirmed. In the remaining four neonates with continuous left-to-right ductal flow, two showed a pan-diastolic flow reversal at the initial examinations 2 to 3 hrs after birth. This became a pan-diastolic forward flow at the second examinations 6 and 12 hrs after birth. In the other two, there was a pan-diastolic forward flow which did not change. This pan-diastolic flow reversal observed in the brachiocephalic artery and descending aorta was closely related to the bidirectional ductal flow.(ABSTRACT TRUNCATED AT 400 WORDS)