Patent Ductus Arteriosus

Ductus arteriosus is an artery which, , drives the blood from the pulmonary artery into the aorta during fetal life. At birth when the neonate start breathing it heals over spontaneously in few hours. Sometimes it can remain opened, allowing blood to flow from the aorta (where the blood pressure is higher at birth) to the pulmonary artery. Larges ductus arteriosus can give symptoms similar to those caused by a large VSD. In the majority of cases they are small and well tolerated.



Superior Vena Cava
Aorta
Pulmonary VeinsPulmonary Veins
Pulmonary Artery
Left Atrium
Right Atrium
Left Ventricle
Right Ventricle
Inferior Vena Cava


-Fig. 4.3
Patent ductus arteriosus. The arrow indicates the defect and the shunt-.


The necessity of closing PDA depends on the overload of the heart represented by the continuous flow of blood from aorta to pulmonary artery, on the risks of infective endarteritis, aneurysmal dilatation and rupture during the years. Surgical closure of PDA is an extracardiac intervention which does not require extracorporal circulation, and involves the ligation and division of the ductus. Nowadays, the large majority of cases is closed by a non surgical method with excellent results using detachable devices. Among these devices, detachable intravascular coils are those used most frequently for their efficiency, safety, the ease of use and handle. Recently a promising new device for ductal closure, the Amplatzer duct occluder II (ADO II), a nitinol flexible mesh, with a symmetrical design to provide high conformability for treatment of all anatomical types of PDA, has received the CE mark approval from the European Community, The ADO II is fabric free and has a symmetrical design, with three articulated mesh lobes. Flexible mesh and dual articulations do provide high conformability for treatment of all anatomical types of PDA, particularly the largest.

 

<<back