Open arterial duct - frequent congenital heart disease

Among the congenital malformations of the cardiovascular system, an open arterial duct occupies a special place, which in general has a very indirect relationship to cardiac abnormalities, since there are no primary disorders of the structure and functioning of the heart with this disease. Normally, this duct, which connects the descending part of the aorta, carrying blood to all organs of the developing fetus, and the pulmonary artery through which blood flows to the lungs, is an indispensable attribute of the embryonic type of circulation. And during the ultrasound of a pregnant woman, it is detected in all children in the womb.

How does the arterial duct function normally?

Actually, to say that the child has an open arterial duct, it is possible only by the end of the first year of the baby's life - the blood flow in this formation under normal conditions weakens after the first inhalation of a newborn and completely ceases for 2-3 months of life. But to say that this defect of the circulatory system really exists, it is possible only in a few months - in some cases, the speed of its obliteration slows down, especially in children who were born prematurely.

The cause of the closure of the blood vessel between the aorta and the pulmonary artery is the spreading of the lungs and the onset of breathing with atmospheric oxygen. Under normal conditions, the level of pressure in the pulmonary artery and aorta is equalized, which creates the prerequisites for stopping the direct connection of the large and small circle of blood circulation. Most often, the arterial duct continues to function in children who have been born prematurely - they simply do not have time to form normally the lung vessels and lung tissue, which is responsible for gas exchange in the body, as well as in infants infected with various infectious agents, including infectious agents Rubella virus. In this case, there is no normal development of the muscular layer of the vascular wall, so the duct can remain open.

How the open arterial duct is manifested

Far from always open arterial duct in children is manifested by a bright clinical picture - often, with a small diameter of such a communicating vessel, the child's physical development is not violated and he is no different from his peers. Children fairly well tolerate an adequate physical load to their age, but can more often healthy children have catarrhal diseases, bronchitis and pneumonia.

In the event that the open arterial duct has a sufficiently large diameter, two variants of the development of events are possible. At the first, easier disruption of the normal functioning of the circulatory system, an additional volume of blood takes place, in which the normal oxygen content, in the pulmonary artery and further, into the blood vessels of the lungs. Accordingly, the return of blood through a small circle of circulation to the left atrium and left ventricle increases, and a gradual thickening of their muscular layer occurs. There is a decrease in the tolerance of physical activity, physical development indicators worsen, inflammatory lung diseases occur several times a season or go to the stage of chronic disease, but the general condition of the body does not suffer for a long time, because the oxygen level in the blood remains normal. In the second, severe variant of the development of the blemish, blood is discharged from the small circle of blood circulation into the large, the gas composition of the blood is sharply disrupted , and, consequently, the processes of metabolism in the tissues. There is a gap in the children's physical development, cyanosis and pallor of the skin, slowing the pace of development.

The program of treatment of an open arterial duct

In the overwhelming majority of cases, regardless of the size of the defect, the open arterial duct should be treated promptly. At present, it is possible to perform a fairly simple surgical operation on the main vessels - without affecting the heart (stopping) and other interventions, a ligation of the functioning duct is performed. In the conditions of modern cardiosurgical centers, it is possible to perform endovascular operations - closure of the duct with the help of an intravascular spiral or obturator.