The ductus arteriosus and stenoses of the pulmonary arteries in pulmonary atresia

Elzenga, Nynke J.; Groot, Adriana C. Gittenberger‐de

doi:10.1016/0167-5273(86)90179-8

Cited by 84 publications

(66 citation statements)

References 11 publications

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“…to have a specific etiology, as ductal tissue of the ductus arteriosus is extended into the wall of the pulmonary artery. 2,3 Constriction of the ductal tissue at birth not only results in ductal closure but also leads to pulmonary artery stenosis because of the ectopic ductal tissue (Skoda's theory). 4 Whether the left or the right pulmonary artery develops a stenosis depends on whether the individual has a left-or right-sided ductus arteriosus.…”

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confidence: 99%

Juxtaductal Coarctation of Both Pulmonary Arteries in a Cat

et al. 2010

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Abstract. A 4-year-old, male, neutered cat was referred because of recurrent episodes of dyspnea. Physical examination revealed a harsh systolic murmur, with the point of maximal intensity in the left heart base, with an intensity of 4 out of 6. Echocardiographic diagnosis was severe supravalvular pulmonary artery stenosis. A selective right ventricular angiocardiogram showed an absence of arterial blood flow to the left lung lobes. A balloon dilatation of the localized stenosis of the right pulmonary artery was attempted with cardiac catheterization. However, when the catheter was passed through the stenosis, the blood flow to the lungs temporarily completely ceased, which led to death. Postmortem examination revealed a circumscribed stenosis of both pulmonary arteries at the site of the bifurcation, where the ligamentum arteriosum was attached. Histopathology showed that the localized ridge-like stenosis at the pulmonary artery bifurcation was caused by connective tissue. The suspected cause of this congenital anomaly is the presence of ectopic ductal tissue in the wall of the pulmonary artery. When the ductus arteriosus closes at birth, pulmonary artery stenosis developed because of constriction of the ectopic ductal tissue.Key words: Cardiology; cats; congenital heart defects; pulmonic stenosis; small animal.A 4-year-old, 3.5-kg, male, neutered European shorthair cat was referred to the Companion Animal Clinic (Utrecht, The Netherlands) for further evaluation of a cardiac murmur and recurrent episodes of dyspnea. During the last event, an overnight hospitalization in an oxygen cage and treatment with parenteral furosemide and oral ramipril by the referring veterinarian resulted in rapid resolution of the clinical signs. As a kitten, the cat was found in the street in Spain and was brought to The Netherlands. During the first health check by the referring veterinarian, a loud cardiac murmur was auscultated, but at that time no further investigation was done. The cat was neutered under medetomidine and isoflurane anesthesia, without any complications.At presentation, the cat was bright, alert, and responsive. No sign of dyspnea was seen. Physical examination revealed a respiratory rate of 20 breaths/min, a pulse rate of 140 beats/ min, and a rectal temperature of 39.1uC. Cardiac auscultation revealed a harsh systolic murmur, with the point of maximal intensity at the left heart base. The intensity of the murmur was 4 out of 6. Before presentation, the cat had been treated with 10 mg furosemide once daily and 0.625 mg ramipril once daily for 6 days.Thoracic radiographs (Fig. 1) showed severe generalized cardiomegaly and a distended caudal vena cava. The pulmonary vessels were within normal limits. Multiple mineralized structures were seen in the lung fields. The largest structure was approximately 1 cm 3 1 cm and was located in the dorsal aspect of the left caudal lung lobe. The second structure was smaller and located in the right cranial lung lobe. A small, round, soft tissue opacity was seen just dorsal to t...

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Juxtaductal Coarctation of Both Pulmonary Arteries in a Cat

et al. 2010

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“…In this patient, there was absence of a main pulmonary artery segment, with continuity between the right and left pulmonary arteries, and bilateral AD. Histologic studies of infants with pulmonary atresia have shown that tissue of the AD is frequently found within the wall of the pulmonary arteries [9,10], and that constriction of ductal tissue can lead to an acquired stenosis or complete isolation of a pulmonary artery. In each of the reported cases by Waldman et al [10], isolation of the pulmonary artery occurred at the site of insertion of the AD, at a range of 4 days to 12 months in age.…”

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confidence: 99%

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Texter

Shah

Carlson

et al. 2007

Cathet Cardio Intervent

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We present a case of a newborn infant with double inlet left ventricle, pulmonary atresia, confluent pulmonary arteries, and bilateral arterial ducts (AD), to discuss the therapeutic alternatives offered by interventional catheterization techniques in this anatomic arrangement. The infant initially underwent stenting of the right AD to stabilize pulmonary blood flow off of prostaglandin infusion. Three weeks later, she developed left pulmonary artery isolation upon closure of the left arterial duct. An additional stent was placed in the pulmonary artery confluence, restoring blood flow to the left lung and significantly improving her oxygen saturations. At 6 months of age she underwent her first surgical procedure, a successful bidirectional cavopulmonary anastomosis with removal of the left pulmonary artery stent and patch enlargement of the pulmonary artery confluence. She continues to do well in clinical follow-up at 16 months of age.

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“…Coarctation of the pulmonary artery is a rare disease first described more than 50 years ago and very common in cases with some degree of stenosis of the right ventricular outflow tract [1][2][3]. Luhmer et al [13] has shown that 36%, nine out of 25 neonates with cyanosis due to obstruction of the right ventricular outflow tract, presented justaductal pulmonary stenosis associated with the invasion of ductal tissue in the pulmonary artery.…”

Section: Discussionmentioning

confidence: 99%

“…Oliveira et al [5] described in our country, in a study of 766 catheterizations assessment that there was pulmonary obstruction in 37.7% of cases with pulmonary atresia, 8.6% in cases with pulmonary stenosis, 17.2% in cases of tetralogy of Fallot and 28.3% in cases of right ventriculcar double outflow tract with pulmonary stenosis. In cases of pulmonary atresia with atresia of the pulmonary trunk, the levels of obstruction can reach 75% [2].…”

Section: Introductionmentioning

confidence: 99%

“…The pulmonary artery stenosis justaductal is extremely common and can occur in up to 60% of cases with pulmonary atresia and up to 10% of patients with pulmonary stenosis [2][3][4]. Oliveira et al [5] described in our country, in a study of 766 catheterizations assessment that there was pulmonary obstruction in 37.7% of cases with pulmonary atresia, 8.6% in cases with pulmonary stenosis, 17.2% in cases of tetralogy of Fallot and 28.3% in cases of right ventriculcar double outflow tract with pulmonary stenosis.…”

Section: Introductionmentioning

confidence: 99%

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Tática para cirurgia de correção da coarctação da artéria pulmonar sem uso de circulação extracorpórea

Oliveira¹,

Monteiro²,

Lino³

et al. 2009

Rev Bras Cir Cardiovasc

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Tática para cirurgia de correção da coarctação da artéria pulmonar sem uso de circulação extracorpóreaApproach for surgical correction of pulmonary artery coarctation without cardiopulmonary bypass Abstract Pulmonary artery coarctation often happens in patients with pulmonary atresia. The correction is usualy on bypass and in the neonatal period, influencing pulmonary artery development and patient prognosis. Three patients with pulmonary atresia depending of PDA where corrected using median sternotomy without cardiopulmonary bypass. The PDA maintained the arterial saturation during Blalock Taussig anastomoses upon the other pulmonary artery. Pulmonary arterioplasty was performed using an autologous pericardium with 7-0 PDS running suture and saturation maintained by Blalock shunt. All patients had good follow up and where discharged with good enlargement of coarctation area.Descriptors: Pulmonary artery. Pulmonary atresia. Heart defects, congenital. Cardiopulmonary bypass. Pulmonary circulation. Resumo 563OLIVEIRA, DM ET AL -Approach for surgical correction of pulmonary artery coarctation without cardiopulmonary bypass Bras Cir Cardiovasc 2009; 24(4): 562-566 Rev

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The ductus arteriosus and stenoses of the pulmonary arteries in pulmonary atresia

Cited by 84 publications

References 11 publications

Juxtaductal Coarctation of Both Pulmonary Arteries in a Cat

Juxtaductal Coarctation of Both Pulmonary Arteries in a Cat

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Tática para cirurgia de correção da coarctação da artéria pulmonar sem uso de circulação extracorpórea

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