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Ductal dependent congenital heart lesions

Ductal dependent lesions are congenital heart defects that require a patent ductus arteriosus (PDA) to maintain adequate blood flow to either the pulmonary or systemic circulation. 1. Common examples include: Pulmonary atresia Hypoplastic left heart Transposition of the great vessels 2. Management: Prostaglandin E2 (PGE2) is used to maintain PDA patency Close monitoring required due to potential complications of PGE2: Hypotension Apnea 3. Physiological basis: PDA normally allows blood flow from pulmonary artery to aorta in utero Normally closes within 12 hours after birth In ductal dependent lesions, closure can be life-threatening due to compromised circulation 4. Other factors affecting PDA: Factors promoting patency: hypoxia, hypercarbia, hypothermia Factors promoting closure: NSAIDs, increased PaO2 Early recognition and prompt PGE2 administration are crucial for survival in these conditions.