Patent ductus arteriosus
Summary
- Patent ductus arteriosus (PDA) is a condition in which a blood vessel called the ductus arteriosus fails to close normally in an infant soon after birth.
- The condition leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels surrounding the heart.
- PDA is common among premature babies, babies with genetic abnormalities such as Down syndrome, and babies whose mothers had German measles during pregnancy.
- Small PDAs often close without treatment. PDAs that don’t close can be treated with medication, a catheter-based procedure, or surgery.
- Most children are healthy and live normal lives after treatment for a patent ductus arteriosus, as long as there are no other congenital heart defects.
Alternative nam
PDA
What is patent ductus arteriosus?
Patent ductus arteriosus (PDA) is a heart problem that occurs after birth in some babies. Before birth, the two major arteries – the aorta and the pulmonary artery – are normally connected by a blood vessel called the ductus arteriosus, which is an essential part of the foetal circulation.
After birth the vessel is supposed to close within a few days as part of the normal changes occurring in the baby’s circulation. However, in some babies the ductus arteriosus remains open (patent).
The opening leads to abnormal blood flow between the aorta and pulmonary artery, which can put a strain on the heart and increase the blood pressure in the lung arteries.
What causes patent ductus arteriosus?
The cause for patent ductus arteriosus is unknown, but doctors believe that genetics may play a role. A defect in one or more genes could prevent the ductus arteriosus from closing normally after birth.
PDA is more common in:
- Premature babies
- Babies with genetic abnormalities such as Down syndrome
- Babies whose mothers had German measles (rubella) during pregnancy
What are the symptoms of patent ductus arteriosus?
- Bounding pulse
- Fast breathing
- Shortness of breath
- Poor feeding habits
- Poor growth
- Sweating while feeding
- Tiring very easily
How is patent ductus arteriosus diagnosed?
In full-term babies, PDA is usually suspected when the doctor hears a heart murmur. If a PDA is large, the baby may also develop symptoms of volume overload and increased blood flow to the lungs.
Doctors may suspect PDA in premature babies who develop breathing difficulties soon after birth.
Two painless tests are used to diagnose PDA:
- Echocardiogram – uses sound waves to create a moving picture of the baby’s heart.
- EKG – records the electrical activity in the heart.
How is patent ductus arteriosus treated?
Small PDAs often close without treatment. PDAs that don’t close on their own may require one of the following treatments:
- Medicine: Medication such as Indomethacin and Ibuprofen helps to close PDAs in premature babies.
- Catheter-based procedures: During this procedure the doctor places a catheter in a large blood vessel in the upper thigh, and guides it to the child’s heart where a small metal coil or other blocking device (Amplatzer device or Raskind umbrella) is passed up through the catheter and placed in the ductus arteriosus to block blood flow through the vessel.
- Thoracoscopic ligation using a clip
- Surgery: Open surgery is done when the catheter-based procedure can’t be performed or wasn’t successful, or if the PDA is too large for a thorascopic procedure. The surgery exposes the PDA which is then closed up with stitches.
What is the prognosis?
Most children are healthy and live normal lives after treatment for a patent ductus arteriosus, as long as there are no other congenital heart defects.
When to call your doctor?
This condition is usually diagnosed by a doctor examining the patient.
How can patent ductus arteriosus be prevented?
Preventing preterm deliveries is the most effective way to prevent PDA.
The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.
