Ductus arteriosus
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Artery: Ductus arteriosus | |
|---|---|
 | |
| Plan of the fetal circulation. ("Ductus arteriosus" visible at upper right.) | |
 | |
| Heart cross-section with PDA | |
| Gray's | subject #139 540 |
| Source | pulmonary artery |
| Branches | aortic arch |
| Vein | ductus venosus |
| MeSH | Ductus+Arteriosus |
| Dorlands / Elsevier | d_29/12314749 |
|
WikiDoc Resources for Ductus arteriosus | |
|
Articles | |
|---|---|
|
Most recent articles on Ductus arteriosus Most cited articles on Ductus arteriosus | |
|
Media | |
|
Powerpoint slides on Ductus arteriosus | |
|
Evidence Based Medicine | |
|
Cochrane Collaboration on Ductus arteriosus | |
|
Clinical Trials | |
|
Ongoing Trials on Ductus arteriosus at Clinical Trials.gov Trial results on Ductus arteriosus Clinical Trials on Ductus arteriosus at Google
| |
|
Guidelines / Policies / Govt | |
|
US National Guidelines Clearinghouse on Ductus arteriosus NICE Guidance on Ductus arteriosus
| |
|
Books | |
|
News | |
|
Commentary | |
|
Definitions | |
|
Patient Resources / Community | |
|
Patient resources on Ductus arteriosus Discussion groups on Ductus arteriosus Patient Handouts on Ductus arteriosus Directions to Hospitals Treating Ductus arteriosus Risk calculators and risk factors for Ductus arteriosus
| |
|
Healthcare Provider Resources | |
|
Causes & Risk Factors for Ductus arteriosus | |
|
Continuing Medical Education (CME) | |
|
International | |
|
| |
|
Businness | |
|
Experimental / Informatics | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
In the developing fetus, the ductus arteriosus (DA) is a shunt connecting the pulmonary artery to the aortic arch that allows most of the blood from the right ventricle to bypass the fetus' fluid-filled lungs. During fetal development, this shunt protects the lungs from being overworked and allows the right ventricle to strengthen. There are two other fetal shunts, the ductus venosus and the foramen ovale.
Eponym
The ductus arteriosus is sometimes called the ductus Botalli, after Leonardo Botallo, although the discovery should have been attributed to Giulio Cesare Aranzi, to whom (less commonly) the ductus venosus is named.[1]
Closure at birth
When the newborn takes its very first breath, pulmonary vascular resistance falls due to physical opening of the pulmonary capillaries and attenuation of intrauterine hypoxic pulmonary vasoconstriction. Decreased pulmonary vascular resistance increases pulmonary blood flow while pulmonary vascular pressure falls below aortic pressure. At the same time, the lungs release bradykinin (vasodilator) and falling prostaglandin levels cause constriction of the smooth muscle in wall of the DA, reducing flow. Bradykinin works by acting on eNOS to increase NO produced, thus inducing vasodilatation. ACE breaks down bradykinin and therefore, ACE inhibitors aid in prolonging the action of vasodilatation by bradykinin. Additionally, because of reduced pulmonary resistance, more blood flows from the pulmonary arteries to the lungs and thus the lungs deliver more oxygenated blood to the left heart. This further increases aortic pressure so that flow in DA may transiently reverse.
Usually, the DA begins to close when breathing is established, and is completely sealed after four to ten days. A cord-like vestige of the DA, called the ligamentum arteriosum, remains to connect the exterior of the left pulmonary artery to the exterior of the aortic arch.
When the ligamentum arteriosum forms it traps the left branch of the recurrent left vagus nerve in the thorax.
Patent ductus arteriosus
Failure of a child's DA to close after birth results in a condition called patent ductus arteriosus and the generation of a left-to-right shunt. If left uncorrected, patency leads to pulmonary hypertension and possibly congestive heart failure and cardiac arrhythmias. Closure may be induced with a drug class known as NSAIDs such as indomethacin or ibuprofen because these drugs inhibit prostaglandin synthesis. Prostaglandins are responsible for maintaining the ductus arteriosus.
References
External links
- Circulatory changes at birth at berkeley.edu
Prenatal development/Mammalian development of circulatory system | |
|---|---|
| Vascular | Blood island
arteries: Dorsal aorta - Aortic arches - Vitelline arteries - Ductus arteriosus - Umbilical artery |
| Heart development | Primitive heart tube: Truncus arteriosus - Bulbus cordis - Primitive ventricle - Primitive atrium - Sinus venosus Septum primum (Ostium primum, Ostium secundum) - Septum secundum (Foramen ovale) - other septa (Endocardial cushions/Septum intermedium, Aorticopulmonary septum) - Atrial canal |
fr:Persistance du canal artériel ja:動脈管開存症 no:Ductus arteriosus nn:Ductus arteriosussr:Дуктус артериозус (Ботали) uk:Відкрита артеріальна протока
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
