Talk:Cardiovascular System - Fetal Shunts
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Cite this page: Hill, M.A. (2019, August 18) Embryology Cardiovascular System - Fetal Shunts. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Cardiovascular_System_-_Fetal_Shunts
The ductus arteriosus: physiology, regulation, and functional and congenital anomalies
Arch Cardiovasc Dis. 2011 Nov;104(11):578-85. Epub 2010 Sep 21.
Gournay V. Source Pediatric cardiology unit, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex, France. email@example.com Abstract Over the last three decades, knowledge about fundamental and clinical aspects of the ductus arteriosus has substantially improved, leading to considerable progress in the management of various cardiac diseases involving the ductus. The identification of the mechanisms regulating ductal patency led to design pharmacological drugs to achieve medical closure of PDA in premature infants, or inversely to maintain patency in neonates with duct-dependent congenital heart diseases. Concurrently, widespread availability of echocardiography has improved the detection of congenital PDA, resulting in earlier treatment. Closure of PDA, by either surgery or transcatheter techniques, can now be achieved safely, resulting in a decrease in the incidence of severe complications of PDA. Copyright © 2010 Elsevier Masson SAS. All rights reserved. PMID 22117910
The control of cardiovascular shunts in the fetal and perinatal period
Can J Physiol Pharmacol. 1988 Aug;66(8):1129-34.
Coceani F, Olley PM. Source Research Institute, Hospital for Sick Children, Toronto, Ont., Canada.
The fetal circulation has two major vascular shunts, the ductus arteriosus and the ductus venosus. The ductus arteriosus connects the pulmonary artery with the descending portion of the aortic arch, hence shunting most of the right ventricular output away from the unexpanded lungs. The ductus venosus connects instead the portal sinus with the inferior vena cava and allows well-oxygenated umbilical vein blood to bypass the liver and reach the central circulation rapidly. Both blood vessels cease their function after birth and undergo permanent closure. It is now well established that prenatal patency of the ductus arteriosus is an active state sustained by a prostaglandin. A similar mechanism has been recently recognized in the fetal ductus venosus. Evidence is presented indicating that prostaglandin E2 and prostaglandin I2 are natural relaxants, respectively, for the ductus arteriosus and the ductus venosus. In addition, both vascular shunts share the dependence on an endogenous cytochrome P-450 mechanism to develop their contractile tone. This mechanism may be important in the normal process of shunt closure at birth. While broadening the knowledge of fetal cardiovascular homeostasis, advances in this field have important implications for the prevention and management of certain pathological conditions affecting the newborn.