Molecular and mechanical factors contributing to ductus arteriosus patency and closure

Congenit Heart Dis. 2019 Jan;14(1):15-20. doi: 10.1111/chd.12714. Epub 2018 Nov 23.

Abstract

Regulation of the ductus arteriosus, an essential fetal vessel connecting the pulmonary artery and aorta, is complex. Failure of this vessel to close after birth may result in a persistent left-to-right shunt through the patent ductus arteriosus, a condition associated with significant morbidities. Numerous factors contribute to the shift from fetal ductus patency to postnatal closure, requiring precise coordination of molecular cues with biomechanical forces and underlying genetic influences. Despite significant advances, questions remain regarding signaling dynamics and the natural time course of ductus closure, particularly in preterm neonates. This review highlights the contributions of early investigators and more recent clinician scientists to our understanding of the molecular and mechanical factors that mediate ductus patency and closure.

Keywords: ductus arteriosus; oxygen; patent ductus arteriosus; prostaglandins.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures / methods*
  • Ductus Arteriosus / diagnostic imaging*
  • Ductus Arteriosus, Patent* / metabolism
  • Ductus Arteriosus, Patent* / psychology
  • Ductus Arteriosus, Patent* / surgery
  • Hemodynamics / physiology*
  • Humans
  • Infant, Newborn
  • Oxidative Stress / physiology*