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In 2008, Bharucha and colleagues examined 300 cases with congenital cardiac malformations and found that 3D echocardiography; mainly the MPR mode, was of great use and changed the management plane in 32 cases. However there were no PDA cases in that study [2]. In the current study the MPR mode was used in all the feasible cases (41 cases were feasibly assessed by QLAB out of 42 cases) where after the duct was adequately visualized from the suprasternal short axis or the left infraclavicular view the MPR mode was used to measure the pulmonary end of the duct in two dimensions (minor and major). The shape of the pulmonary end was found to be elliptical rather than rounded and the two dimensions [http://www.selleck.co.jp/products/Verteporfin(Visudyne).html selleckchem] measured differed from those measured by 2D echocardiography or angiography. We postulate that 3D echocardiography might be measuring the pulmonary end from a different angle than that measured by angiography and 2D echocardiography. [http://www.selleck.co.jp/products/Bleomycin-sulfate.html Bleomycin cell line] Anwar and colleagues studied the right ventricular outflow tract (RVOT) and the pulmonary valve in 50 adult cases. They compared the measurement of RVOT diameter and the PV annulus using both 2D and 3D echocardiography. In accordance to our results, the authors concluded that the RVOT was oval not circular, 2D diameters were underestimated and smaller than 3D diameters which mean they were tangential rather than true cut sections [1]. In the current study the aortic end of the duct measured by 3D guided method was better than 2D echocardiography when both were compared with the gold standard angiography. The length of the duct was also measured in a 3D guided MPR mode and had better agreement with angiography than the classic 2D echocardiogram measurements. We postulate that the third dimension and the ability of 3D echocardiography to determine the [https://en.wikipedia.org/wiki/Mephenoxalone Mephenoxalone] depth of anatomic structures improved assessment of the length of the PDA compared to 2D echocardiogram. The anatomical type of the duct was determined using 3D gated color flow across the PDA followed by black and white suppression. The shape of the duct appeared after cropping of the image as a colored cast that resembles more or less a 3D angiographic display of the duct. When feasible 3D echocardiography color flow mapping provided excellent angiographic display of full extent of the PDA flow from the aortic to the pulmonary ends. Moreover, with rotation of the volume, different views of the duct can be displayed simulating the lateral and RAO angiographic views that allowed better understanding of the ductal morphology. The anatomical type of the duct was determined according to Krichenko classification [7] (Fig. 7). Our technique of gated 3D color flow with black and white suppression was adopted from the technique used by Mallek et al.