Ductus Dependent Circulation

Ductus Dependent Circulation Ductus dependent circulation is one in which a patent ductus arteriosus is useful in maintaining the circulation after birth. It is important to rule out such conditions before any PDA closure is planned. PDA dependent circulations can be PDA dependent pulmonary circulation, PDA dependent systemic circulation and PDA dependent mixed circulation. The first group includes pulmonary atresia, tricuspid atresia and tetralogy of Fallot with pulmonary atresia. In those cases, post natal physiological constriction of ductus arteriosus can cause severe hypoxemia, cyanosis and even death. In these cases, there is severe restriction of pulmonary blood flow and pulmonary circulation is dependent on a PDA [1]. Second group of conditions with severe restriction of systemic blood flow include severe aortic stenosis, coarctation of aorta, interrupted aortic arch and hypoplastic left heart syndrome. Postnatal constriction of PDA can cause systemic hypoperfusion, shock, metabolic acidosis and death. In the third group as in transposition of great arteries, both systemic and pulmonary circulations are dependent on adquate mixing as both circulations are in series. Maintaining a PDA is one method of providing mixing between systemic and pulmonary circulations. In all these situations, ductal patency can be maintained by prostaglandin E1 infusion as a temporary measure till other procedures can be done. Continuous infusion is needed as 60-80% of PGE1 is metabolized on...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs