From the Guidelines
The ligamentum arteriosum is located adjacent to the origin of the left subclavian artery, near the pulmonary trunk. This location is significant in understanding the anatomy of the great vessels and the potential for associated lesions, such as aortic coarctation, which can occur in the region of the ligamentum arteriosum 1. The ligamentum arteriosum is a fibrous cord that represents the remnant of the fetal ductus arteriosus, which during fetal development shunted blood from the pulmonary trunk directly to the aorta.
- Key points to consider:
- The ligamentum arteriosum is located near the origin of the left subclavian artery
- It is adjacent to the pulmonary trunk
- Associated lesions can occur in this region, including aortic coarctation
- The ligamentum arteriosum forms part of the vascular ring around the trachea and esophagus
- Identifying the ligamentum arteriosum is important during surgical procedures involving the great vessels to avoid inadvertent injury to nearby structures, such as the recurrent laryngeal nerve, which loops around it on the left side before ascending to the larynx, as described in the context of aortic coarctation 1.
From the Research
Location of Ligamentum Arteriosum
- The ligamentum arteriosum is located between the pulmonary trunk and the aortic arch, specifically at the site where the ductus arteriosus connected the left pulmonary artery to the aortic arch during fetal development 2.
- It is described as the vestigial fibrous remnant of the ductus arteriosus, which arises from the left dorsal segment of the sixth aortic arch 2.
- The ligamentum arteriosum is attached to the pulmonary trunk and the aortic arch, and its contractile abilities may act on these two great vessels, causing a change in their distensibility 3.
- In some cases, the ligamentum arteriosum can cause kinking at its insertion sites, leading to bilateral branch pulmonary artery obstruction 4.
- The ligamentum arteriosum is innervated, with nerve terminals present close to smooth muscle cells, which may play a role in vessel compliance or impedance of the two great vessels related to this structure 5.
- Ruptures of the aortic arch and pulmonary trunk have been reported near the ligamentum arteriosum, due to media necrosis probably caused by intimal thickening and/or medial fibrosis of the vasa vasorum 6.