The effect of patent ductus arteriosus on coronary artery blood flow in premature infants: a prospective observational pilot study

Objective To compare coronary flows between premature infants with and without hemodynamically significant patent ductus arteriosus (hsPDA) and to determine if coronary flow is influenced by medical PDA treatment. Design Prospective, observational pilot study. Forty-three infants <32 weeks gestation underwent echocardiography when routinely indicated. Study group included infants with hsPDA requiring treatment. Comparison groups included infants with nonsignificant PDA and infants without PDA. Results The study group ( n = 13), compared with the comparison groups with nonsignificant PDA ( n = 12) and without PDA ( n = 18) had higher troponin levels ( p = 0.003 and 0.004, respectively). In infants with hsPDA compared with infants with no PDA there was a significant increase in myocardial oxygen demand and decrease in left main coronary artery flow, with nonsignificant increase in cardiac output. Conclusions Decrease in coronary artery flows and higher troponin values may suggest a “steal effect,” not allowing to meet the elevated myocardial oxygen demand in infants with hsPDA.