AI Article Synopsis
- The ductus arteriosus (DA) is a vital fetal blood vessel that connects the pulmonary artery to the aorta, typically closing within 24-72 hours after birth due to increased oxygen levels.
- In cases of delayed closure or duct-dependent cardiac defects, medical and surgical methods, like stenting or shunting, are used to keep the DA open for survival.
- Studies show that stenting leads to lower morbidity and shorter recovery times compared to shunting, although the longevity of stents is still a concern.
Article Abstract
The ductus arteriosus (DA) connects the pulmonary artery to the aorta to bypass the pulmonary circulation in utero. It normally closes within 24-72 hours after birth due to increased pulmonary resistance from an increase in oxygen partial pressure with the baby's first breath. Medical treatment can help close the DA in certain situations where closure is delayed. However, in duct-dependent cardiac defects, the presence of the DA is crucial for survival and as such medical and surgical techniques have evolved to prevent closure. This review aims to outline the two main management options for keeping a ductus arteriosus patent. This includes stenting the PDA and shunting via a modified Blalock-Taussig shunt. Whilst both techniques exist, multicentre trials have found equal mortality end points but significantly reduced morbidity with stenting than shunting. This is also reflected by shorter recovery times, reduced requirement for extracorporeal membrane oxygenation (ECMO), and improved quality of life, although stent longevity remains a limiting factor.
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| http://dx.doi.org/10.1017/S1047951120004126 | DOI Listing |
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