Fantoms
TARGETING THE DUCT
Echoing the duct, and measuring parameters such as left atrial size, will always be the mainstay of assessment for babies where there is clinical suspicion of a significant patent duct. Routine anti-duct treatment of all babies under a certain birth weight or gestation, though briefly fashionable, has faded out through lack of convincing evidence. The new and interesting question is whether to actively seek out those babies with a significant duct earlier than symptoms develop, and treat it if it fulfils criteria for being actually or potentially haemodynamically significant. Exactly what is meant by “significant” is a matter for debate, but Farombi-Oghuvbu et al have made a contribution by demonstrating that N-terminal pro-B-type natriuretic peptide concentrations may be a useful marker for “significance”. Exactly how such measurements may be used, and how they may add value to, or substitute for echocardiography, will need further …
