Open arteriosus (Botallo) duct is located between the pulmonary artery trunk and the aorta. It opens into the aorta. This canal is functioning in the fetus during intrauterine development. Lungs before birth do not work and through the duct between the pulmonary artery and aorta maternal blood, bypassing the lungs, enters the systemic circulation. When a child is born it is unnecessary, and gradually the ductus arteriosus closes. Normally the closure of the duct occurs in two stages. Within 10-15 hours after delivery contracts the muscular layer of its wall, the duct is shortened. Then, gradually growing connective tissue, are deposited platelets, a clot is formed, and by the third week of life the duct closes. Ductus arteriosus occurs in one in 2000 newborn birth. Size it is usually 4-12 mm long and 2-8 mm wide.
In patent ductus arteriosus blood from the aorta, because there the pressure is higher in the pulmonary artery is cleared. The volume of blood in the pulmonary circulation increases dramatically and may exceed the amount of blood in a large circle three times. Most of the blood circulating in this case in the lungs and other organs and tissues receive less oxygen, are in a constant state of oxygen deficiency. Increased pressure in the vessels of the lungs leads to stagnation in the lungs, creating conditions for inflammatory lung diseases. Then the vessels sclerotherapy, their function is impaired.
Infants with patent ductus arteriosus are lagging behind in development. Complain of fatigue, shortness of breath with a small load. Usually they are inactive. More adults may complain of palpitations, irregular heart area. Often there are pneumonia (lung inflammation).
The diagnosis of patent ductus arteriosus is established on the basis of the survey:
expanded the boundaries of the heart, auscultation auscultated characteristic of this disease sistolodiastolichesky rude noise, the so-called "machine" noise on the electrocardiogram are no changes, forcing suspected patent ductus arteriosus echocardiography revealed the presence of a characteristic of blood flow in a typical location between the aorta and the pulmonary artery toward the aorta to the pulmonary artery
X-ray images of the lungs are judged on the degree of changes in lung tissue.
Conservative treatment of patent ductus arteriosus does not exist. This is an absolute indication for surgery. Surgical treatment of the defect produced in 1938. It was the first the operated heart disease. Tactics of surgical treatment of open arterial defect is well designed. Performed a simple duct ligation or suturing. Mortality in the surgical treatment of minimal and amounts to 0.2-3%. At about 0.1% of the operated flow may again be opened, then performed a second operation.
In recent years, intravascular surgery performed in minimal access, which is less traumatic for the child and accelerates post-operative recovery period (recovery).
The best age for operation of the closure of the ductus arteriosus from 3 to 5 years. The process of full recovery after surgery lasts about a year and depends on the degree of changes in the lungs.