What percentage of patent ductus arteriosus (PDA) is detectable on transthoracic 2-dimensional (2D) echocardiography (echo)?

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Last updated: April 1, 2025 • View editorial policy

From the Research

Transthoracic 2D echocardiography (TTE) can detect approximately 42% of patent ductus arteriosus (PDA) cases, as reported in the study by 1. The detection rate varies based on several factors including the size of the PDA, patient characteristics, and the skill of the echocardiographer. Some key points to consider:

  • Small PDAs may be more difficult to visualize directly, particularly in adults with poor acoustic windows or in patients with pulmonary hypertension where the shunt direction may be reversed.
  • TTE typically identifies PDAs through direct visualization of the ductus itself, color Doppler demonstration of abnormal flow between the aorta and pulmonary artery, and spectral Doppler showing continuous flow in the pulmonary artery.
  • In cases where TTE results are inconclusive but clinical suspicion remains high, transesophageal echocardiography (TEE) may be used, which has a higher sensitivity approaching 97%, as reported in the study by 1.
  • Other imaging modalities such as cardiac CT, MRI, or cardiac catheterization may be necessary for definitive diagnosis in the remaining cases where echocardiography is insufficient, particularly for very small PDAs or in patients with complex anatomy.
  • More recent studies, such as the one by 2, have shown that TTE can be used to guide transcatheter closure of PDA, with a high success rate and minimal complications.
  • Another study by 3 demonstrated the technical feasibility and clinical relevance of using TTE as an alternative to angiography for transcatheter closure of PDA.

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