Peripheral arterial contrast echocardiography: a new method for the detection of left-to-right shunting patent ductus arteriosus.

A modified echocardiographic method (peripheral arterial contrast echocardiography, PACE) using suprasternal notch (SSN) echocardiography and rapid hand injection of 5% glucose solution through peripheral arteries is introduced. This method was used to determine the presence of a left-to-right shunting via patent ductus arteriosus (PDA) in 50 patients with various congenital heart disease among neonates, infants, and young children. Echocardiographic findings were compared with cardiac catheterization/angiography, surgery, and/or autopsy. Diagnosis of PDA made by PACE was sensitive in 98.5% and specific in 100% of cases. Thus, the PACE examination is a reliable bed-side technique to detect qualitatively the presence or absence of a left-to-right shunting PDA accompanied with acyanotic or cyanotic heart disease.