Learn About Patent Ductus Arteriosus
Patent ductus arteriosus (PDA) is a condition in which the ductus arteriosus does not close. The word "patent" means open.
The ductus arteriosus is a blood vessel that allows blood to go around the baby's lungs before birth. Soon after the infant is born and the lungs fill with air, the ductus arteriosus is no longer needed. It most often closes in a couple of days after birth. If the vessel doesn't close, it is referred to as a PDA.
PDA leads to abnormal blood flow between the 2 major blood vessels that carry blood from the heart to the lungs and to the rest of the body.
PDA
PDA is more common in girls than boys. The condition is more common in premature infants and those with neonatal respiratory distress syndrome. Infants with genetic disorders, such as Down syndrome, or babies whose mothers had rubella during pregnancy are at higher risk for PDA.
PDA is common in babies with congenital heart problems, such as hypoplastic left heart syndrome, transposition of the great vessels, and pulmonary stenosis.
A small PDA may not cause any symptoms. However, some infants may have symptoms such as:
- Fast breathing
- Poor feeding habits
- Rapid pulse
- Shortness of breath
- Sweating while feeding
- Tiring very easily
- Poor growth
If there are no other heart defects present, often the goal of treatment is to close the PDA. However, if the baby has certain other heart problems or defects, keeping the ductus arteriosus open may be lifesaving. Medicine may be used to stop it from closing.
Sometimes, a PDA may close on its own. In premature babies, it often closes within the first 2 years of life. In full-term infants, a PDA that remains open after the first several weeks rarely closes on its own.
When treatment is needed, medicines such as indomethacin or ibuprofen are often the first choice. Medicines can work very well for some newborns, with few side effects. The earlier treatment is given, the more likely it is to succeed.
A medication called prostaglandin E1 may be used to keep the PDA open if necessary until other defects are treated.
If these measures do not work or can't be used, the baby may need to have a medical procedure.
A transcatheter device closure is a procedure that uses a thin, hollow tube placed into a blood vessel. The doctor passes a small metal coil or other blocking device through the catheter to the site of the PDA. This blocks blood flow through the vessel. These coils can help the baby avoid surgery.
Surgery may be needed if the catheter procedure does not work or it cannot be used due to the baby's size or other reasons. Surgery involves making a small cut between the ribs to repair the PDA.
John Dagle is a Neonatologist and a Pediatrics provider in Iowa City, Iowa. Dr. Dagle is rated as an Elite provider by MediFind in the treatment of Patent Ductus Arteriosus. His top areas of expertise are Patent Ductus Arteriosus, Premature Infant, High Blood Pressure in Infants, and Intraventricular Hemorrhage of the Newborn. Dr. Dagle is currently accepting new patients.
Pediatric Cardiology In Lawrenceville
Bryan H. Goldstein MD, FACC, FSCAI is a pediatric interventional cardiologist and is certified in pediatric cardiology by the American Board of Pediatrics. He is director of the cardiac catheterization laboratory and interventional cardiology service at UPMC Children’s Hospital of Pittsburgh and is a Professor of Pediatrics at the University of Pittsburgh School of Medicine. He received his medical degree from Boston University School of Medicine and completed his residency at the Boston Combined Residency in Pediatrics (Children’s Hospital Boston) and fellowship at C.S. Mott Children’s Hospital (University of Michigan Medicine). Dr. Goldstein joined the UPMC Heart and Vascular Institute in 2019. His clinical interests include congenital cardiac catheterization, minimally invasive transcatheter therapies, and single ventricle (Fontan) circulation. Dr. Goldstein has published numerous scientific articles in peer-reviewed journals, is a frequent faculty member and presenter at national and international meetings, and is a member of Alpha Omega Alpha Honor Medical Society, American Academy of Pediatrics (FAAP), American Heart Association, American College of Cardiology (FACC) and Society for Cardiovascular Angiography & Interventions (FSCAI). He is vice president of the Congenital Cardiac Research Collaborative (CCRC). View Dr. Goldstein's full list of publications from PubMed. Dr. Goldstein is rated as an Elite provider by MediFind in the treatment of Patent Ductus Arteriosus. His top areas of expertise are Congenital Cardiovascular Shunt, Tetralogy of Fallot, Pulmonary Atresia, Stent Placement, and Angioplasty.
Patrick Mcnamara is a Neonatologist and a Pediatrics provider in Iowa City, Iowa. Dr. Mcnamara is rated as an Elite provider by MediFind in the treatment of Patent Ductus Arteriosus. His top areas of expertise are Patent Ductus Arteriosus, High Blood Pressure in Infants, Premature Infant, and Bronchopulmonary Dysplasia. Dr. Mcnamara is currently accepting new patients.
If a small PDA stays open, the baby may eventually develop heart symptoms. Babies with a larger PDA could develop heart problems such as heart failure, high blood pressure in the arteries of the lungs, or an infection of the inner lining of the heart if the PDA does not close.
This condition is most often diagnosed by the provider who examines your infant. Breathing and feeding problems in an infant can sometimes be due to a PDA that has not been diagnosed.
Women who plan to become pregnant should be immunized against rubella if they are not already immune. Rubella infection in a pregnant woman can cause congenital heart disease.
Women who are pregnant should get good prenatal care:
- Avoid alcohol and illegal drugs during pregnancy.
- Tell your provider that you are pregnant before taking any new medicines.
- Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery.
- Pregnant women who have diabetes should try to get good control over their blood sugar level.
Certain genes may play a role in congenital heart disease. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history of congenital heart disease.
Summary: Patent ductus arteriosus (PDA), the most common cardiovascular complication of prematurity, is associated with higher mortality and morbidities in extremely low gestational age neonates (ELGANs, \< 27+0 weeks). Ibuprofen and acetaminophen, which act by reducing prostaglandin synthesis, are the most commonly used first and second line agents for PDA treatment across Canada. However, initial treatme...
Summary: Newborns born early are at risk for a serious health problem called patent ductus arteriosus (PDA). PDA is a passageway between heart and lung that can cause life-threatening complications such as bleeding in the brain or even death if it remains open and large. When closure of PDA is needed, doctors make every attempt to do it as soon as possible. Ibuprofen is the best drug to close the PDA, but ...
Published Date: October 23, 2023
Published By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Valente AM, Dorfman AL, Babu-Narayan SV, Kreiger EV. Congenital heart disease in the adolescent and adult. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 82.
Well A, Fraser CD. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 59.