Condition 101 About Patent Ductus Arteriosus

What is the definition of 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.

What are the alternative names for Patent Ductus Arteriosus?

PDA

What are the causes for Patent Ductus Arteriosus?

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.

What are the symptoms for Patent Ductus Arteriosus?

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

What are the current treatments for Patent Ductus Arteriosus?

If there are no other heart defects present, often the goal of treatment is to close the PDA. 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.

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.

What is the outlook (prognosis) for Patent Ductus Arteriosus?

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.

When should I contact a medical professional for Patent Ductus Arteriosus?

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.

Heart
Patent

REFERENCES

Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease in the adult and pediatric patient. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 75.

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Latest Advances On Patent Ductus Arteriosus

  • Condition: Patent Ductus Arteriosus (PDA) in Children with Pulmonary Artery Hypertension
  • Journal: Texas Heart Institute journal
  • Treatment Used: Transcatheter Closure
  • Number of Patients: 33
  • Published —
This study investigated whether transcatheter device closure of patent ductus arteriosus (hole in heart; PDA) is safe in children with pulmonary artery hypertension (high blood pressure).
  • Condition: Symptomatic Patent Ductus Arteriosus in Preterm Infants
  • Journal: The Cochrane database of systematic reviews
  • Treatment Used: Indomethacin
  • Number of Patients: 880
  • Published —
The study researched the use of indomethacin for treating symptomatic patent ductus arteriosus in preterm infants.

Clinical Trials For Patent Ductus Arteriosus

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Procedure
  • Participants: 60
  • Start Date: March 1, 2021
Prophylactic vs Early Rescue Less Invasive Surfactant Administration in Extremely Preterm Infants