UTILITY OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE EXAMINATION OF ADULT PATIENTS WITH PATENT DUCTUS-ARTERIOSUS

Thirteen patients with clinical suspicion of patent ductus arteriosus were evaluated by transthoracic and transesophageal echocardiographic studies. Findings were corroborated during corrective surgery in 8 pat ients and by cardiac catheterization in 5. Transthoracic echocardiogra phy confirmed the diagnosis in 7 patients; in 2 of the patients endart eritis of the pulmonary artery was demonstrated, and in one infective vegetations in aortic and mitral valves. With transesophageal echocard iography, patent ductus arteriosus was established in all 8 patients a nd endarteritis of the pulmonary artery was shown in 3, including 1 no t discovered by transthoracic technique. In 1 of these patients, veget ations were also found on the pulmonic valve, Both techniques demonstr ated significant pulmonary hypertension in 5 cases; contrast studies s howed the venoarterial shunt between the pulmonary artery and the aort a with particular clarity in transesophageal images. On the basis of t hese findings it may be concluded that transesophageal echocardiograph y complements the information provided by transthoracic recordings in adult patients with patent ductus arteriosus, especially when it is as sociated with pulmonary hypertension or pulmonary endarteritis.