Ductus arteriosus

A key arterial shunt (ductus) in fetal life. Before birth, blood pumped from the heart through the pulmonary artery toward the lungs is shunted into the aorta. This arterial shunt is a short vessel called the ductus arteriosus. When the shunt is open, it is said to be patent. The ductus arteriosus usually closes at or shortly after birth, permitting blood from that moment on to course from the heart directly to the lungs. However, if the ductus arteriosus remains open (patent), flow reverses and blood from the aorta is shunted left-to-right into the pulmonary artery and thence recirculated through the lungs. A PDA may close spontaneously (on its own). If not, it needs to be prompted pharmacologically to close and, if that does not work, it must ligated (tied off) surgically. PDA is a particularly common problem in premature infants with the respiratory distress syndrome. The left-to-right shunt through the ductus increases their risk of serious complications including brain hemorrhage. IV indomethacin (Indocin) was the conventional therapy to promote closure of PDA in premies but indomethacin affects blood flow to organs such as the kidney and so may lead to complications such as renal failure. Ibuprofen (the active ingredient in Advil, Motrin, Medipren and Nuprin) has been found to work as well as indomethacin in treating PDA in preterm infants with the respiratory distress syndrome and is less likely to impair their kidney function.

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ductus ar·te·ri·o·sus -är-.tir-ē-'ō-səs n a short broad vessel in the fetus that connects the pulmonary artery with the aorta and conducts most of the blood directly from the right ventricle to the aorta bypassing the lungs

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a blood vessel in the fetus connecting the pulmonary artery directly to the ascending aorta, so bypassing the pulmonary circulation. It normally closes after birth. Failure of the ductus to close (patent ductus arteriosus) produces a continuous murmur, and the consequences are similar to those of a septal defect. It may close spontaneously in childhood but often requires surgical closure.

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[TA] arterial duct: a fetal blood vessel connecting the left pulmonary artery directly to the descending aorta; called also arterial canal and duct of Botallo.