[Absence of arterial duct in fetus: an autopsy analysis]

J F Shang1, D Chen1, W Fang1

  • 1Department of Pathology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.

Insights

The absence of the arterial duct in fetuses is frequently linked to congenital heart disease. This study highlights associations between pulmonary atresia, systemic-pulmonary collateral circulation, and visceral malformations.

Area of Science:

  • Fetal Cardiology
  • Pediatric Cardiovascular Surgery
  • Medical Imaging

Background:

  • Congenital heart disease (CHD) encompasses a range of structural abnormalities present at birth.
  • The arterial duct (ductus arteriosus) is a crucial fetal blood vessel that typically closes shortly after birth.
  • Understanding variations in fetal cardiovascular anatomy, such as the absence of the arterial duct, is vital for prenatal diagnosis and management.

Purpose of the Study:

  • To investigate the incidence and characteristics of the absent arterial duct in fetuses diagnosed with congenital heart disease.
  • To enhance the diagnostic accuracy of fetal echocardiography in identifying this anomaly and associated conditions.

Main Methods:

  • Analysis of 400 fetal cases diagnosed with congenital heart disease via prenatal echocardiography.
  • Examination of fetal cardiovascular and visceral malformations in conjunction with the presence or absence of the arterial duct.

Main Results:

  • The absence of the arterial duct was identified in 24 (6%) of the cases.
  • Commonly associated cardiovascular malformations included pulmonary artery stenosis (15 cases) and pulmonary atresia (7 cases).
  • Associated visceral malformations, such as asplenia and visceral inversion, were noted in 7 cases each.

Conclusions:

  • Absence of the arterial duct is a significant finding often co-occurring with congenital heart disease.
  • Pulmonary atresia in this context frequently presents with systemic-pulmonary collateral circulation.
  • Visceral malformations appear to be related to the co-existing congenital cardiovascular malformations.