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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.
In the fetus, there is a special connection between the pulmonary artery and the aorta, called the ductus arteriosus. [2] Because the aorta has lower pressure than the pulmonary artery, most of the blood flows across the ductus arteriosus away from the lungs. [1]
During fetal development, the ductus arteriosus is kept open by high levels of a vasodilator prostaglandin E2 which is made by the placenta and by the ductus arteriosus itself. At birth a bunch of things change, though—oxygen levels in the blood go up dramatically and the lungs become the main source of oxygenated blood.
The ductus arteriosus connects at a junction point that has a low pressure zone (commonly called Bernoulli's principle) created by the inferior curvature (inner radius) of the artery. This low pressure region allows the artery to receive ( siphon ) the blood flow from the pulmonary artery which is under a higher pressure.
Functional closure of the ductus arteriosus occurs within the first 24 hours, with permanent closure following within 4 weeks. Lastly cardiac output increases to nearly double what it was in utero. All of these cardiovascular system changes result in the adaptation from fetal circulation patterns to an adult circulation pattern.
This begins with the formation of two endocardial tubes which merge to form the tubular heart, also called the primitive heart tube. The heart is the first functional organ in vertebrate embryos. The tubular heart quickly differentiates into the truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and the sinus venosus.
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Persistent fetal circulation is a condition caused by a failure in the systemic circulation and pulmonary circulation to convert from the antenatal circulation pattern to the "normal" pattern. Infants experience a high mean arterial pulmonary artery pressure and a high afterload at the right ventricle.