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The ductus arteriosus in neonates with critical congenital heart disease

Journal of Perinatology volume 42, pages 1708–1713 (2022)Cite this article

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Abstract

The ductus arteriosus (DA) has a paradoxical biological role in neonates with congenital heart disease (CHD) and can present with significant management challenges. Critical congenital cardiac lesions rely on the patency of the DA to provide either systemic or pulmonary blood flow. A patent DA (PDA) that remains open can also have adverse consequences depending on the degree of systemic to-pulmonary shunting and volume of ductal steal. As such, the presence of a PDA may pose a challenge in the medical management and timing of surgical repair. In this perspective article, we provide an understanding of the role of the DA in the circulatory system in neonates with CHD and discuss traditional and emerging approaches to support the pulmonary and systemic circulations with manipulation of the DA.

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Fig. 1: Intravascular Devices.

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Author information

Authors and Affiliations

  1. Department of Respiratory Care & ECMO, Boston Children’s Hospital, Boston, MA, USA

    Craig R. Wheeler

  2. Division of Neonatology and Pediatric Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Shawn Sen

  3. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Philip T. Levy

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  1. Craig R. Wheeler
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  2. Shawn Sen
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  3. Philip T. Levy
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Contributions

PL, SS, RW conceptualized the study, shared writing of the first draft critically reviewed the manuscript, and approved submission.

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Correspondence to Philip T. Levy.

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Wheeler, C.R., Sen, S. & Levy, P.T. The ductus arteriosus in neonates with critical congenital heart disease. J Perinatol 42, 1708–1713 (2022). https://doi.org/10.1038/s41372-022-01449-8

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