HUMAN FETAL CIRCULATION: CHANGES IN THE CARDIOVASCULAR SYSTEM AT BIRTH AND DISTURBANCES IN THE POST-NATAL CLOSURE OF THE FORAMEN OVALE AND DUCTUS ARTERIOSUS

The ductus arteriosus and foramen ovale were described by Galen without understanding their functions. His beliefs in soul localization and spiritization within the left ventricle established religious pneumatology which became a theological need in the Middle Ages. Pulmonary transit was recognized by Servetus and Colombo after the Reformation around 1550. This prompted Harvey’s full understanding of the fetal circulation. Botallo did not describe the ductus arteriosus, but in 1564 redescribed the foramen ovale, making his way into the Nomina Anatomica by mistake. Most authors of the 19th and 20th centuries believed ductal patency to be passive, and postnatal closure to be an active process, explained by mechanical theories. After the discovery of prostaglandins by Bergstrom and Vane, Coceani proved that ductal patency is maintained by the relaxant action of prostaglandins.

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Mathematical model of the fetal cardiovascular system: the uncontrolled case

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1980.239.3.r317 ◽

1980 ◽

Vol 239 (3) ◽

pp. R317-R325 ◽

Cited By ~ 1

Author(s):

F. Huikeshoven ◽

T. G. Coleman ◽

H. W. Jongsma

Keyword(s):

Mathematical Model ◽

Ductus Arteriosus ◽

Circulatory System ◽

Cardiovascular Physiology ◽

Control Mechanisms ◽

Foramen Ovale ◽

Fetal Circulation ◽

Upper Limits ◽

The Individual ◽

The Right

A mathematical model was developed to study and to interpret the results of different experiments undertaken in the field of fetal cardiovascular physiology. This model consists of a total of six peripheral blood compartments and a detailed description of the heart. The unique characteristics of the fetal circulation, particularly the ductus arteriosus, the foramen ovale, and the placenta are incorporated into this model. No control mechanisms are incorporated. The model was validated by simulating several previously described experiments. First, the performance of the individual ventricles was measured. The results indicate that, in the normal physiological situation, the right ventricle is working near the upper limits of its function while the left ventricle works below its limits. Second, the circulatory system was stressed by increasing the blood volume and the results show a shift from right to left in the relative contributions of each ventricle to the total cardiac output. Finally, effects of clamping the several blood vessels of the umbilical cord were studied.

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Hová vezet a Botallo-vezeték? Tévedéshezr

Magyar Sebészet (Hungarian Journal of Surgery) ◽

10.1556/maseb.61.2008.suppl.5 ◽

2008 ◽

Vol 61 (Supplement-1) ◽

pp. 13-16 ◽

Cited By ~ 2

Author(s):

Árpád Péterffy ◽

Mikael Péterffy

Keyword(s):

Ductus Arteriosus ◽

Foramen Ovale

Absztrakt A közlemény célja, hogy felhívja a hazai orvostársadalom figyelmét arra a tényre, hogy helytelen “ductus Botalli”-nak nevezni a pulmonalis arteria és az aorta közti artériás vezetéket (ductus arteriosus), amely a magzati keringés fontos része, és ezért nyitva van, de a születés után, a tüdővel való légzés során feleslegessé válik, és elzáródik. A 16. században élt olasz Leonardo Botallo által leírt és saját magáról elnevezett anatómiai képlet a foramen ovale. Sajnálatos módon könyvének későbbi kiadásában történt meg a tévesztés, és társították össze a ductus arteriosust az olasz orvos és hadisebész nevével. Továbbá a mű németre való fordítása is hozzájárulhatott a tévedéshez, ugyanis a “ductus Botalli” elnevezés német nyelvterületen, Skandináviában és Magyarországon terjedt el, viszont az angolszász és spanyol orvosirodalomban nem. Tekintettel arra, hogy a “ductus Botalli” elnevezés tévedésen alapul, fölöttébb kívánatos lenne ennek a hibás elnevezésnek mellőzése a magyar orvosi nyelvben, hasonlóan a német és skandináv nyelvű orvosi irodalomhoz, ahol ez már megtörtént.

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Molecular Mechanisms Underlying Remodeling of Ductus Arteriosus: Looking beyond the Prostaglandin Pathway

International Journal of Molecular Sciences ◽

10.3390/ijms22063238 ◽

2021 ◽

Vol 22 (6) ◽

pp. 3238

Author(s):

Ho-Wei Hsu ◽

Ting-Yi Lin ◽

Yi-Ching Liu ◽

Jwu-Lai Yeh ◽

Jong-Hau Hsu

Keyword(s):

Adverse Effect ◽

Clinical Management ◽

Vascular Remodeling ◽

Molecular Mechanisms ◽

Surgical Intervention ◽

Ductus Arteriosus ◽

Clinical Problem ◽

Cyclooxygenase Inhibitors ◽

Medical Patients ◽

Fetal Circulation

The ductus arteriosus (DA) is a physiologic vessel crucial for fetal circulation. As a major regulating factor, the prostaglandin pathway has long been the target for DA patency maintenance or closure. However, the adverse effect of prostaglandins and their inhibitors has been a major unsolved clinical problem. Furthermore, a significant portion of patients with patent DA fail to respond to cyclooxygenase inhibitors that target the prostaglandin pathway. These unresponsive medical patients ultimately require surgical intervention and highlight the importance of exploring pathways independent from this well-recognized prostaglandin pathway. The clinical limitations of prostaglandin-targeting therapeutics prompted us to investigate molecules beyond the prostaglandin pathway. Thus, this article introduces molecules independent from the prostaglandin pathway based on their correlating mechanisms contributing to vascular remodeling. These molecules may serve as potential targets for future DA patency clinical management.

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