Patent Ductus Arteriosus

Chapter

Abstract

The ductus arteriosus is a normal fetal structure arising from the left sixth aortic arch. It is a vascular connection between the main pulmonary artery and the upper descending thoracic aorta that penetrates the pericardium and just distal and opposite to the origin and insertion of the left subclavian artery. The anatomy of the thorax is essential to identifying and safely closing a PDA as several important structures surround the ductus. The left vagus trunk enters the chest from the root of the neck in a groove between the left subclavian artery and the left common carotid artery, crosses the aortic arch as well as the ductus and continues downward. The recurrent laryngeal branch curves around the ductus arteriosus posteriorly and extends back upward into the neck over the surface of the esophagus. The left phrenic nerve enters the thorax medial to the vagus nerve and continues downward on the pericardium. The pericardium encompasses the pulmonary artery end of the ductus arteriosus.

Keywords

Fatigue Surfactant Catheter Ischemia Foam 

Suggested Reading

  1. Gould DS, Montenegro LM, Gaynor JW, et al. A comparison of on-site and off-site patent ductus arteriosus ligation in premature infants. Pediatrics. 2003;112:1298–300.CrossRefPubMedGoogle Scholar
  2. Gross RE, Hubbard JP. Surgical ligation of a patent ductus arteriosus. Report of first successful case. JAMA. 1939;112:729.Google Scholar
  3. Heymann MA, Rudolph AM, Silverman NJ. Closure of the ductus arteriosus in premature infants by inhibition of prostaglandin synthesis. N Engl J Med. 1976;295:530–3.CrossRefPubMedGoogle Scholar
  4. Mavroudis C, Backer CL, Gevitz M. Forty-six years of PDA division at Children’s Memorial Hospital of Chicago. Standards for comparison. Ann Surg. 1994;220:402.CrossRefPubMedGoogle Scholar
  5. Villa E, Eynden FV, Le Bret E, et al. Paediatric video-assisted thoracoscopic clipping of patent ductus arteriosus: experience in more than 700 cases. Euro J Cardiothor Surg. 2004;25:387–93.CrossRefGoogle Scholar
  6. Wagner HR, Ellison RC, Zierler S, et al. Surgical closure of patent ductus arteriosus in 268 preterm infants. J Thorac Cardiovas Surg. 1984;87:870.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Cardiothoracic SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

Personalised recommendations