PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Ductus Arteriosus”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1978

Histopathology of the ductus arteriosus after prostaglandin E1 administration in ductus dependent cardiac anomalies.

The histology of the ductus arteriosus was studied after prostaglandin E1 (PGE1) administration in 4 infants with ductus dependent cardiac malformations. Pronounced pathological changes were found in each instance. The changes consisted of oedema of the media with separation of medial components by clear spaces, pathological interruptions of the internal elastic lamina, and intimal lacerations, some of which extended into the media. The findings suggest that PGE1 administration has a profound weakening effect on the structure of the wall of the ductus arteriosus, rendering the vessel prone to laceration.

Ductus Arteriosus↗
PubMed1975

Control of the ductus arteriosus.

In the fetus the major function of the ductus arteriosus is to divert flow away from the lungs toward the placenta, therby avoiding unnecessary circulation through the lungs and reducing the work load of the heart. Constriction of the ductus arteriosus is produced by several mechanisms that may interact with one another in producing normal postnatal closure of the ductus arteriosus. The major mechanism is the constrictor effect of an increased O2 environment. This may directly affect the ductus arteriosus muscle or may work through the release of an intermediary substance. Other vasoactive substance circulating in the blood after birth may also play some role in constriction of the ductus arteriosus. There are major species differences in the degree and type of response to the various stimuli and the exact mechanisms ultimately responsible for closure are not yet fully understood.

Acetylcholine↗
PubMed1976

Pharmacologic closure of patent ductus arteriosus in the premature infant.

The prostaglandins affect smooth-muscle tone of the ductus arteriosus. Patent ductus often complicates the clinical course of prematurely born infants with respiratory-distress syndrome. In the present study, a single oral or rectal dose of a potent inhibitor of prostaglandin synthesis, indomethacin, was administered to six consecutive premature infants with the syndrome who would otherwise have undergone surgical ligation of the patent ductus. Within 24 hours all the clinical symptoms and physical, echocardiographic and radiographic signs attributable to substantial left-to-right shunting through a patent ductus arteriosus dramatically and permanently disappeared. A transient reduction in renal function was observed in two infants in whom sustained ill-effects did not occur. The observation that constriction and closure of the patent ductus arteriosus may be induced pharmacologically raises important possibilities for the improved treatment of the respiratory-distress syndrome.

Cyclooxygenase Inhibitors↗
PubMed1978

Chest film diagnosis of patent ductus arteriosus in infants with hyaline membrane disease.

Patent ductus arteriosus in an infant with hyaline membrane disease is usually a serious complication. To evaluate the diagnostic role of chest radiography in these infants, a double-blind study comparing patients with both hyaline membrane disease and patent ductus arteriosus and matched controls was undertaken. Three pediatric radiologists acted as observers. In no instance were they more reliable than chance in predicting the presence of a patent ductus arteriosus. Analysis according to various clinical criteria (e.g., severity of illness, PAO2) also failed to show any subgroup in which the observers were accurate. From these data it is concluded that chest radiography does not play a significant role in the diagnosis of patent ductus arteriosus in infants with hyaline membrane disease.

Clinical Trials as Topic↗
PubMed1992

Evidence for an effector role of endothelin in closure of the ductus arteriosus at birth.

The ductus arteriosus is a special muscular shunt that in the fetus allows blood to bypass the unexpanded lungs. It closes rapidly after birth and this event is initiated by the physiologic rise in blood oxygen tension. Endothelin-1 has been proposed by us as a local mediator for oxygen after demonstrating that it is formed within the ductus and is a potent ductus constrictor. To confirm this possibility, we have now measured the release of endothelin-1 from the isolated ductus of near-term fetal lambs at different oxygen concentrations of the medium. In addition, using the same preparation, we have examined the effect on contractile tone of compounds interfering with the synthesis (phosphoramidon, 50 microM) and action (BQ123, 1 microM) of endothelin-1. We report that release of endothelin-1 from the ductus tends to increase with the oxygen concentration up to a value mimicking the neonatal condition. Phosphoramidon and, to a greater degree, BQ123 inhibit the contraction of the vessel to oxygen. These results implicate endothelin-1 as the effector agent for oxygen in the ductus and, by extension, assign to this peptide a critical role in the closure of the vessel at birth.

Animals↗
PubMed1977

Transposition of the great arteries with intact ventricular septum and patent ductus arteriosus.

At the time of initial balloon atrial septostomy a patent ductus arteriosus was found with angiography in 39 of 81 infants with transposition of the great arteries with intact ventricular septum. By angiographic criteria the ductus shunt was considered small in 21 infants and large and significant in 18. In contrast to the usual clinical presentation of neonates with transposition and intact ventricular septum, 12 of these 18 infants with a significant patent ductus arteriosus had only slight cyanosis and 8 presented with tachypnea out of proportion to the degree of cyanosis. Ten of the 18 infants had no continuous murmur, bounding pulses, mid-diastolic rumble or differential cyanosis. Clinically occult narrowing or closure occurred, presumably gradually and relatively late, in six infants. Acute early narrowing or closure, spontaneous (six infants) or surgically produced (three infants), occurred usually within the 1st month of life and was associated with a marked decrease in arterial oxygen saturation in eight infants, often with a rapid clinical deterioration. Persistence of a large patent ductus arteriosus for several months appears to be associated with an increased incidence of early pulmonary vascular disease. Therapeutic considerations for the infant with a large patent ductus arteriosus after initial balloon atrial septostomy include: (1) careful initial follow-up of the infant in clinically stable condition in case the ductus arteriosus should acutely narrow or close and the patient require urgent palliative or corrective surgery; (2) urgent early closure of the ductus in the infant with overt left heart failure with concurrent atrial septectomy or preferably primary corrective surgery; and (3) elective closure of a persistent significant patent ductus arteriosus before age 4 months with concurrent corrective surgery in the infant in clinically stable condition.

Abnormalities, Multiple↗
PubMed1992

Atrial natriuretic peptide in the diagnosis of patent ductus arteriosus.

The aim of this study was to measure plasma atrial natriuretic peptide in preterm infants with a patent ductus arteriosus before and after closure with indomethacin. Atrial natriuretic peptide was measured in 28 preterm infants with clinical and echocardiographic evidence of a patent ductus arteriosus and in eight preterm infants who did not develop clinical evidence of a patent ductus arteriosus. Plasma concentration of atrial natriuretic peptide was measured by radioimmunoassay. In 18 infants the patent ductus arteriosus closed after one course of indomethacin; atrial natriuretic peptide levels decreased from median 1240 pg/ml (range 201-5483 pg/ml) to 266 pg/ml (range 62-1108 pg/ml). In four infants the patent ductus arteriosus closed after two courses of indomethacin and two infants had surgical ligation after indomethacin treatment failed. The patent ductus arteriosus closed spontaneously in four infants (atrial natriuretic peptide median level 152 pg/ml, range 61-495 pg/ml). In the eight infants without patent ductus arteriosus, atrial natriuretic peptide level was median 224 pg/ml (range 38-876 pg/ml). Measurement of plasma atrial natriuretic peptide concentration has a role in predicting when indomethacin treatment is indicated.

Atrial Natriuretic Factor↗
PubMed1977

Ductus arteriosus dilatation by prostaglandin E1 in infants with pulmonary atresia.

Infants with pulmonary atresia depend on patency of the ductus arteriosus for survival in the immediate postnatal period. Despite continuing hypoxemia after birth the ductus arteriosus usually constricts, thus reducing pulmonary blood flow. This often occurs while awaiting surgical palliation or correction, leading either to marked deterioration in the infant's condition, or death. In ten infants with pulmonary atresia, we infused prostaglandin E1 (PGE1) at a rate of 0.1 mug/kg/min in six and 0.05 mug/kg/min in four into the descending aorta at the orifice of the ductus arteriosus. The ductus arteriosus was effectively dilated; at the narrowest point the diameter, measured in eight infants, almost doubled. In all ten infants arterial blood PO2 increased, averaging 24.6 mm Hg before and 43.7 mm Hg after the infusion was started. Infusion of PGE1 directly into the aorta adjacent to the ductus arteriosus avoided the complications of pyrexia, muscular twitching, and excitability which may be related to the effects of prostaglandins on the central nervous system.

Cardiac Catheterization↗
PubMed1977

Early functional closure of the ductus arteriosus associated with decreased severity of respiratory distress syndrome in preterm infants.

It has been shown that a patent ductus arteriosus may complicate the course of the respiratory distress syndrome (RDS) in preterm infants. In this study, an attempt is made to answer the question: Is there any relationship between RDS and patency of the ductus arteriosus in preterm infants, that is, do preterm infants without the RDS have early functional closure of the ductus arteriosus? Clinical observations were made on 144 preterm infants 25 to 34 weeks' gestation. Infants were included in the study if the status of the ductus arteriosus (open or closed) could be established either by clinical examination or retrograde aortography. The ductus arteriosus was closed in 59 infants within 48 hours of birth and open in 85. None of the infants with a closed ductus had severe RDS and only three had mild RDS. In contrast, 50% (43 of 85) of infants with open ductus had severe RDS. These findings suggest that early functional closure of the ductus can occur even in very immature infants, and this early closure appears to be associated with a decreased incidence of RDS.

Aortography↗
PubMed1975

[Surgical treatment of patent ductus arteriosus].

The experience gained with 1400 operations for patent ductus arteriosus performed at the Clinic of the Hospital Surgery of the Gorky Medical Institute during the period from October 1955 through 1973 is presented. The total post-operative lethality comprised 1.3 per cent, it amounting to 6 per cent with complicated patent ductus arteriosus, to 3 per cent among children of junior age and to 0.1 per cent in cases of uncomplicated defect. An analysis of operative and post-operative complications along with a study into remote results of the surgical intervention helped define indications for the closure of the duct in patients with pulmonary hypertension and septic endarteritis. They also showed the possibility of a single-stage correction of combined congenital heart defects. Indications have been worked out for the surgical treatment of patent ductus arteriosus in infants and procedures for the closure of the duct, depending upon its apatomic variants and concomitant complications.

Adolescent↗
PubMed1976

Maturation of contractile response of ductus arteriosus to oxygen and drugs.

Contractile responses of rings of ductus arteriosus from fetal and neonatal guinea pigs were studied in buffered Krebs-Henseleit solutions of various oxygen tensions. Oxygen-induced contraction of ductus arteriosus increased with gestational age, peaking at term and attenuating within 24 h after birth. Contractions of ductus in response to potassium were not different in term and preterm fetuses. Maximal contractile response of pre- and postductal aortic rings to oxygen was 8.3% of the maximal oxygen-induced contraction of ductal rings from the same fetuses. Pulmonary artery was quite insensitive to oxygen. Of 12 ductus exposed to bradykinin in the absence of oxygen seven contracted (maximal response was obtained with 15.0 ng/ml). Exposure of ductus to bradykinin in the absence of oxygen enhanced subsequent contractions of ductal smooth muscle rings to air. Atropine failed to inhibit the oxygen-induced contraction of ductus. These data suggest that acetylcholine is not essential for oxygen-induced contraction of the guinea pig ductus arteriosus.

Acetylcholine↗
PubMed1977

Ductus arteriosus responses to prostaglandin E1 at high and low oxygen concentrations.

It previously has been suggested that prostaglandin E1 (PGE1) relaxes the ductus arteriosus in a low but not in an elevated oxygen environment. However, in the experiments reported here PGE1 relaxed rings on fetal lamb ductus arteriosus in vitro at both low (14 to 20 torr) and high (680 to 720 torr) oxygen tensions. The threshold concentration for PGE1 was 10(-10) M in either PO2 and the ED50's of PGE1 relaxation in high and low oxygen were 8.5 +/- 3.4 x 10(-10) M and 5.5 +/- 0.7 x 10(-10) M respectively. The magnitude of the relaxation was greater for the oxygen contracted ductus arteriosus than for that exposed to low oxygen. It is suggested that earlier reports of the lack of response of the ductus arteriosus to PGE1 in a high oxygen environment following relaxation in a low oxygen environment may be related to loss of response of the ductus arteriosus to repeated doses of PGE1 rather than to differences in PO2. Prostaglandin E1 therefore may play a significant role in the regulation of ductus arteriosus tone in the elevated oxygen environment of the newborn as well as the low oxygen environment of the fetus.

Animals↗
PubMed1977

Management of bilateral ductus arteriosus in complex cyanotic heart disease.

Bilateral ductus arteriosus (BDA) usually is associated with complex cyanotic heart disease. Since pulmonary valve atresia often is part of the complex, hypoxia may necessitate emergency cardiac catheterization and surgery for these critically ill newborn infants. Optimum management depends on accurate delineation of the intracardiac and great vessel anatomy. Since the ductus arteriosus has a tendency to close spontaneously, the true anatomy of the fourth to sixth aortic arch connections should be determined on the first catheterization. An over-all plan for future care by the medical-surgical team should have been made at the time of the initial surgical procedure. The case histories of four newborn infants with BDA associated with cyanotic heart diseases are reported. The anatomy and basic embryology of the fourth to sixth arch system is reviewed and recommendations for long-term management are given.

Aorta, Thoracic↗