Patent ductus arteriosus closure

Summary

The ductus arteriosus is a vascular structure that connects the proximal descending aorta to the roof of the main pulmonary artery near the origin of the left pulmonary artery. It normally closes spontaneously within 24 to 48 hours after birth by the contraction of medial smooth muscle in the vessel wall, due to the increased oxygen tension and reduced prostaglandin E2 and I2 levels. Endothelial adhesion followed by replacement of the muscle fibres with connective tissue results in the formation of the ligamentum arteriosum within two to three weeks. If this does not happen, there is a patent or persistent ductus arteriosus (PDA).

Introduction

The incidence of PDA is approximately 1 in 2,000 in full-term infants and represents 5% to 10% of all congenital heart disease in children. PDA is found twice as often in females than in males. In adulthood, a PDA is not often encountered since it is usually discovered and treated during childhood 1. Presence of a PDA beyond the first...