Patent ductus arteriosus Botalla is a congenital heart defect that is already diagnosed in newborns. This type of cardiovascular anomaly requires immediate diagnosis and intervention by a surgeon, because patent ductus arteriosus can lead to the development of heart failure and delay the child's physical development. What symptoms indicate a patent ductus arteriosus? How is this type of defect treated? How does the operational closure of the duct work?

Patent ductus arteriosus (PDA) , otherwise openBotalla duct , patent Botalla duct, is a congenital heart defect that is one of the the most common defects in children, especially premature babies (it accounts for about 10% of birth defects in children).

Patent ductus arteriosus of Botalla - what is it? When does it close?

Botalla ductus arteriosusis a fetal structure - a short blood vessel connecting the left trunk of the pulmonary artery to the descending aorta so that the blood passes the developing lungs of the fetus. It is essential in fetal life because the pathway of blood flow in the fetus is different from that after birth. A developing baby in a mother's body does not breathe through her lungs because they are flooded with amniotic fluid. It is therefore unnecessary to transport blood from the heart to the lungs. The fetus receives oxygen-rich blood through the umbilical cord. Immediately after birth, when the baby takes the first breath, the amount of oxygen in the arterial blood rises. As a result of this process, the walls of the arterial duct contract, which becomes twisted and spontaneously closes, as it ceases to fulfill its current function.

If the tube does not close, it is called a patent ductus arteriosus. This cardiovascular anomaly is more common in premature babies than full-term babies because the cells in the ductus arteriosus are sensitive to factors that cause it to close. Therefore, the later it is delivered, the less likely it is that the ductus arteriosus will survive.

What pathologies of the circulatory system does the patent ductus arteriosus cause?

If the duct is not closed, the blood that flows into the aorta during contractions, instead of flowing into the tissues of the entire body, flows throughthe patent ductus arteriosus to the pulmonary artery and to the lungs. It is estimated that even 50-70 percent. blood pumped into the systemic circulation may escape into the pulmonary circulation.

This creates a leak from the systemic circulation to the pulmonary circulation, leading to volume overload of the left atrium of the heart and pulmonary circulation. This may lead to left ventricular failure and pulmonary hypertension. The consequence is hindered gas exchange and the development of respiratory failure. It can also damage the right ventricle and, in the most severe case, irreversible sclerosis (Eisenmenger's syndrome).

Patent ductus arteriosus of Botalla - symptoms

The symptoms of a patent Botalla ductus arteriosus depend on the size of the leak. With a slight left-to-right shunt, the course may be asymptomatic. Moderate and severe shunt causes left ventricular failure. In this case,Botalla duct in the newbornmay contribute to the appearance of symptoms such as:

  • cry a lot
  • cough and shortness of breath
  • insufficient weight gain (compared to he althy peers)
  • frequent respiratory infections

An important symptom is the rapid fatigue of the baby during feeding.

Patent ductus arteriosus - diagnosis

During the examination, a systolic-diastolic murmur is heard, best heard in the left subclavian region.

When measuring blood pressure, attention is drawn to low diastolic blood pressure.

The following are also helpful in recognizing the defect:

  • EKG (left ventricular hypertrophy visible)
  • Doppler ultrasound (assesses blood flow in large arteries and veins)
  • Chest X-ray
  • cardiac catheterization

Patent ductus arteriosus Botalla - treatment. How does the operational closure of the duct work?

Patent ductus arteriosus is a defect that requires immediate correction as it may lead to the development of heart failure and endocarditis.

In premature babies diagnosed withBotalla ductpharmacological treatment is attempted. During the therapy, drugs are administered to lower the level of prostaglandins, the high level of which causes the expansion of the lumen of the duct. It is only after 3 months that children can be qualified for surgery as the tubing usually closes at this time.

In children weighing more than 10 kg,the patent ductus arteriosusis tied with a thread during surgery.

The most modern method is the percutaneous procedure, which involves the endovascular closure of the Botlah tube with a catheter and a spring.

The prognosis is very good after each treatment.

Category:

Cardiology