Cardiovascular System - Fetal Shunts: Difference between revisions
No edit summary |
|||
(3 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
==Introduction== | ==Introduction== | ||
[[File:Fetal Circulation Pathway.jpg|thumb| | [[File:Fetal Circulation Pathway.jpg|thumb|400px|Fetal circulation]] | ||
Fetal circulation differs from the adult predominantly due to the presence of 3 vascular shunts located within the heart and in the vasculature. | Fetal circulation differs from the adult predominantly due to the presence of 3 vascular shunts located within the heart and in the vasculature. | ||
* Foramen ovale - in the heart, between the right and left atrium. | * Foramen ovale - in the heart, between the right and left atrium. | ||
* Ductus arteriosus - in the outflow tract, between the pulmonary artery and descending aorta. | * Ductus arteriosus - in the outflow tract, between the pulmonary artery and descending aorta. | ||
* Ductus venosus - in the liver circulation, between the umbilical vein and IVC. | |||
{{Heart Links}} | {{Heart Links}} | ||
Line 15: | Line 15: | ||
|-bgcolor="F5FAFF" | |-bgcolor="F5FAFF" | ||
| | | | ||
* | * <ref><pubmed></pubmed></ref> | ||
|} | |||
==Foramen Ovale== | |||
==Ductus Arteriosus== | |||
==Ductus Venosus== | |||
==Abnormalities== | |||
===Atrial Septal Defects=== | |||
{| | |||
| [[File:Atrial Septal Defect.jpg|300px]] | |||
| Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomolies defects occuring in a number of different forms and more often in females. | |||
* patent foramen ovale- allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists. | |||
* ostium secundum defect | |||
* endocardial cushion defect involving ostium primum | |||
* sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava. | |||
* common atrium | |||
[[Cardiovascular_System_-_Abnormalities#International_Classification_of_Diseases|'''ICD-10''']] Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect | |||
Treatment: The surgical repair requires a cardiopulmonary bypass and is recommended in most cases of ostium secundum ASD, even though there is a significant risk involved. Ostium primum defects tend to present earlier and are often associated with endocardial cushion defects and defective mitral or tricuspid valves. In such cases, valve replacement may be necessary and the extended operation has a considerable chance of mortality. | |||
* Increasingly closure by a transcatheter device closure has been applied. | |||
* Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) <ref><pubmed>19876418</pubmed></ref> | |||
:'''Links:''' [[Cardiovascular_System_-_Atrial_Septal_Defects|Atrial Septal Defects]] | [http://www.ncbi.nlm.nih.gov/omim/108800 OMIM: Atrial Septal Defect] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Atrial%20Septal%20Defect Search PubMed] | [http://www.orlive.com/akronchildrens/videos/transcatheter-repair-of-atrial-septal-defect?view=displayPageNLM Medline Plus - ASD Repair Video] | |||
|} | |||
===Patent Ductus Arteriosus=== | |||
{| | |||
| [[File:Patent Ductus Arteriosus.jpg|300px]] | |||
| Patent ductus arteriosus (PDA), or Patent arterial duct (PAD), occurs commonly in preterm infants, and at approximately 1 in 2000 full term infants and more common in females (to male ratio is 2:1). Can also be associated with specific genetic defects, [[trisomy 21|trisomy 21]] and [[trisomy 18|trisomy 18]], and the Rubinstein-Taybi and CHARGE syndromes. The opening is asymptomatic when the duct is small and can close spontaneously (by day three in 60% of normal term neonates), the remainder are ligated simply and with little risk, with transcatheter closure of the duct generally indicated in older children. The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood. | |||
[[Cardiovascular_System_-_Abnormalities#International_Classification_of_Diseases|'''ICD-10''']] Q25.0 Patent ductus arteriosus Patent ductus Botallo Persistent ductus arteriosus | |||
<gallery> | |||
File:Patent ductus arteriosus classification.jpg|Patent ductus arteriosus classification | |||
File:Patent ductus arteriosus echocardiogram.jpg|PDA echocardiogram | |||
File:Patent ductus arteriosus angiogram.jpg|PDA angiogram | |||
</gallery> | |||
:'''Links:''' [[Cardiovascular_System_-_Patent_Ductus_Arteriosus|Patent Ductus Arteriosus]] |[http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Patent%20Ductus%20Arteriosus Search PubMed] | |||
|} | |} | ||
Line 28: | Line 77: | ||
<pubmed></pubmed> | <pubmed></pubmed> | ||
<pubmed></pubmed> | <pubmed></pubmed> | ||
<pubmed></pubmed> | <pubmed>22117910</pubmed> | ||
<pubmed></pubmed> | <pubmed>21513818</pubmed> | ||
===Articles=== | ===Articles=== |
Latest revision as of 14:38, 2 October 2012
Introduction
Fetal circulation differs from the adult predominantly due to the presence of 3 vascular shunts located within the heart and in the vasculature.
- Foramen ovale - in the heart, between the right and left atrium.
- Ductus arteriosus - in the outflow tract, between the pulmonary artery and descending aorta.
- Ductus venosus - in the liver circulation, between the umbilical vein and IVC.
Some Recent Findings
Foramen Ovale
Ductus Arteriosus
Ductus Venosus
Abnormalities
Atrial Septal Defects
Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomolies defects occuring in a number of different forms and more often in females.
ICD-10 Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect Treatment: The surgical repair requires a cardiopulmonary bypass and is recommended in most cases of ostium secundum ASD, even though there is a significant risk involved. Ostium primum defects tend to present earlier and are often associated with endocardial cushion defects and defective mitral or tricuspid valves. In such cases, valve replacement may be necessary and the extended operation has a considerable chance of mortality.
|
Patent Ductus Arteriosus
Patent ductus arteriosus (PDA), or Patent arterial duct (PAD), occurs commonly in preterm infants, and at approximately 1 in 2000 full term infants and more common in females (to male ratio is 2:1). Can also be associated with specific genetic defects, trisomy 21 and trisomy 18, and the Rubinstein-Taybi and CHARGE syndromes. The opening is asymptomatic when the duct is small and can close spontaneously (by day three in 60% of normal term neonates), the remainder are ligated simply and with little risk, with transcatheter closure of the duct generally indicated in older children. The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.
ICD-10 Q25.0 Patent ductus arteriosus Patent ductus Botallo Persistent ductus arteriosus
|
References
Reviews
<pubmed></pubmed> <pubmed></pubmed> <pubmed></pubmed> <pubmed>22117910</pubmed> <pubmed>21513818</pubmed>
Articles
<pubmed></pubmed> <pubmed></pubmed> <pubmed></pubmed> <pubmed></pubmed> <pubmed></pubmed>
Search Pubmed
Search Pubmed: Cardiovascular Fetal Shunt