Systemic to pulmonary collateral arteries.

Abstract

To the Editor:We read with interest the article by Shaughnessy et al.1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar regarding the development of systemic to pulmonary collateral arteries in premature infants.We observe SPCA quite often in premature infants at approximately the same age as well.There are constantly 2 striking findings in these patients. (1) With the color Doppler sonography we can see these vessels originating from the aorta, but we cannot see with which vessels of the pulmonary circulation they communicate. We do not think that in Fig 1, p. 764, top panel,1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar the connection to the main pulmonary artery is demonstrated, just the origination of the SPCA from the descending aorta, because we cannot see any blood flow in the pulmonary artery. (2) We consistently find low systolic-diastolic blood flow velocities in these SPCA (as you can also see in Fig 1, p. 764, bottom panel1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar). If the SPCA would enter directly into “real” pulmonary arteries, this finding would suggest pulmonary arterial hypertension in these patients. We could rule out pulmonary hypertension in our patients. Ascher et al2Ascher DP Rosen P Null DM deLemos RA Wheller JJ. Systemic to pulmonary collaterals mimicking patent ductus arteriosus in neonates with prolonged ventilatory courses.J Pediatr. 1985; 107: 282-284Abstract Full Text PDF PubMed Scopus (24) Google Scholar measured normal pulmonary arterial pressures in their 2 patients with large SPCA during heart catheterization. Thus we do not think that these collaterals communicate directly with the pulmonary arteries.We believe that if we would know with which vessels of the complex pulmonary circulation these SPCA communicate, we might find out more about the purpose and stimulus for their development.We agree with the authors that this phenomenon is transient, at least in patients without symptoms. To the Editor:We read with interest the article by Shaughnessy et al.1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar regarding the development of systemic to pulmonary collateral arteries in premature infants.We observe SPCA quite often in premature infants at approximately the same age as well.There are constantly 2 striking findings in these patients. (1) With the color Doppler sonography we can see these vessels originating from the aorta, but we cannot see with which vessels of the pulmonary circulation they communicate. We do not think that in Fig 1, p. 764, top panel,1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar the connection to the main pulmonary artery is demonstrated, just the origination of the SPCA from the descending aorta, because we cannot see any blood flow in the pulmonary artery. (2) We consistently find low systolic-diastolic blood flow velocities in these SPCA (as you can also see in Fig 1, p. 764, bottom panel1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar). If the SPCA would enter directly into “real” pulmonary arteries, this finding would suggest pulmonary arterial hypertension in these patients. We could rule out pulmonary hypertension in our patients. Ascher et al2Ascher DP Rosen P Null DM deLemos RA Wheller JJ. Systemic to pulmonary collaterals mimicking patent ductus arteriosus in neonates with prolonged ventilatory courses.J Pediatr. 1985; 107: 282-284Abstract Full Text PDF PubMed Scopus (24) Google Scholar measured normal pulmonary arterial pressures in their 2 patients with large SPCA during heart catheterization. Thus we do not think that these collaterals communicate directly with the pulmonary arteries.We believe that if we would know with which vessels of the complex pulmonary circulation these SPCA communicate, we might find out more about the purpose and stimulus for their development.We agree with the authors that this phenomenon is transient, at least in patients without symptoms. We read with interest the article by Shaughnessy et al.1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar regarding the development of systemic to pulmonary collateral arteries in premature infants. We observe SPCA quite often in premature infants at approximately the same age as well. There are constantly 2 striking findings in these patients. (1) With the color Doppler sonography we can see these vessels originating from the aorta, but we cannot see with which vessels of the pulmonary circulation they communicate. We do not think that in Fig 1, p. 764, top panel,1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar the connection to the main pulmonary artery is demonstrated, just the origination of the SPCA from the descending aorta, because we cannot see any blood flow in the pulmonary artery. (2) We consistently find low systolic-diastolic blood flow velocities in these SPCA (as you can also see in Fig 1, p. 764, bottom panel1Shaughnessy RD Reller MD Rice MJ McDonald RW. Development of systemic to pulmonary collateral arteries in premature infants.J Pediatr. 1997; 131: 763-765Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar). If the SPCA would enter directly into “real” pulmonary arteries, this finding would suggest pulmonary arterial hypertension in these patients. We could rule out pulmonary hypertension in our patients. Ascher et al2Ascher DP Rosen P Null DM deLemos RA Wheller JJ. Systemic to pulmonary collaterals mimicking patent ductus arteriosus in neonates with prolonged ventilatory courses.J Pediatr. 1985; 107: 282-284Abstract Full Text PDF PubMed Scopus (24) Google Scholar measured normal pulmonary arterial pressures in their 2 patients with large SPCA during heart catheterization. Thus we do not think that these collaterals communicate directly with the pulmonary arteries. We believe that if we would know with which vessels of the complex pulmonary circulation these SPCA communicate, we might find out more about the purpose and stimulus for their development. We agree with the authors that this phenomenon is transient, at least in patients without symptoms.