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Page 22 of 41 Rao. Vessel Plus 2022;6:25 https://dx.doi.org/10.20517/2574-1209.2021.92

Figure 37. Two-dimensional (A) and color Doppler (B) images from subcostal views demonstrating a sinus venosus atrial septal defect
(SVASD) in 2D (arrow) (A) with a left-to-right shunt (Sh) (arrow in B). Left atrium (LA) and right atrium (RA) are marked. Modified
from Ref. [16] .

Figure 38. Selected video frames from apical short-axis (A, B) and apical four-chambered (C) views, illustrating mitral valve cleft (MC)
(arrows in A, B) in two separate stages of cardiac contraction in a patient with an ostium primum atrial septal defect (PASD) (C). Left
atrium (LA), left ventricle (LV), right atrium (RA), and right ventricle (RV) are marked.

the PDA [Figures 48 and 49].

While the clinical diagnosis of PDA with echocardiographic confirmation is relatively simple in infants,
children, adolescents, and adults (since the indication for PDA closure is straight forward), it is more
problematic in identifying hemodynamically significant PDAs (hsPDAs) in premature infants. The hsPDAs
can be clearly identified and quantified by echocardiographic examination [36-38] . The left atrial diameter
[Figures 50 and 51]; LA:Ao ratio [Figure 52]; the LV dimension [Figure 53]; PA pressure estimation (see the
section on “Methods of Estimation of Pulmonary Artery Pressure” of Part I of this series); minimal ductal
diameter [Figure 54]; the magnitude of flow velocity through the ductus, measured by Doppler [Figure 49];
and descending aortic Doppler flow velocity pattern [Figures 55 and 56] facilitate the identification of the
size of the PDA.

Examples of small, medium, and large PDAs are shown in [Figures 56-58].