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Patent ductus arteriosus (PDA) is a medical condition in which the ductus arteriosus fails to close after birth: this allows a portion of oxygenated blood from the left heart to flow back to the lungs from the aorta, which has a higher blood pressure, to the pulmonary artery, which has a lower blood pressure.
The ductus arteriosus, also called the ductus Botalli, named after the Italian physiologist Leonardo Botallo, is a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs.
The pattern of pulse abnormalities is dependent upon the classification; e.g., for type B interrupted aortic arch, the right brachial pulse will be palpable and the left brachial and femoral pulses will be impalpable due to closure of the ductus arteriosus. [3] Rarely, an interrupted aortic arch can be associated with an intracranial aneurysm. [6]
The removal of the placenta, a source of prostaglandin, is another mechanism by which the ductus arteriosus closes at birth. [8] Within the next 2 to 3 weeks, the constriction results in decreased blood flow to the structure which induces the death of the tissue to keep the structure permanently closed.
Many patients are diagnosed prenatally. Color Doppler (type of echocardiography) measures the degree of pulmonary stenosis. Additionally, close monitoring of the ductus arteriosus is done in the neonatal period to ensure that there is adequate blood flow through the pulmonary valve. [25] [51]: 171–172
Eisenmenger syndrome or Eisenmenger's syndrome is defined as the process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension [1] [2] and eventual reversal of the shunt into a cyanotic right-to-left shunt.
If that ductus arteriosus doesn’t close off, then the baby is left with a patent ductus arteriosus, and this condition accounts for about 10% of all congenital heart defects, of which the vast majority, about 90%, are isolated heart defects, meaning there aren’t any additional congenital defects.
In adults, the ligamentum arteriosum has no useful function. It is a vestige of the ductus arteriosus, a temporary fetal structure that shunts blood from the pulmonary arteries to the aorta. This significantly reduces the volume of blood circulating through the lungs, which are inactive in the womb.