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Your child has been diagnosed with a patent ductus arteriosus (PDA). The ductus arteriosus is a normal structure in a baby’s heart before birth. It’s a blood vessel that connects 2 arteries: the pulmonary artery and the aorta. The pulmonary artery carries blood from the heart to the lungs. The aorta carries blood from the heart to the body. The ductus arteriosus normally closes shortly after birth. It’s called a PDA when it stays open, or “patent.” A PDA can lead to worsening heart function over time, but it can be easily treated.
With a PDA, blood flows from the aorta through the PDA into the pulmonary artery. This causes increased blood flow to the lungs. If the PDA is large, too much blood goes to the lungs and recirculates to the left ventricle. This can cause pulmonary edema (fluid buildup in the lungs). Then the baby has a hard time breathing and feeding.
In severe cases, the combination of the increased blood flow to the lungs and work to the left ventricle can lead to congestive heart failure (CHF). This is a condition in which the heart no longer pumps blood well.
Most children with a small PDA have no symptoms. Children with a large PDA are more likely to have symptoms. These can include:
Trouble breathing or rapid breathing
Slow weight gain
Frequent respiratory infections
Heart problems in children are usually diagnosed and treated by a doctor called a pediatric cardiologist. Signs of a heart problem will be checked for during a physical exam. To confirm a diagnosis or learn more about a possible heart problem, several tests may also be done. These include:
Chest X-ray. X-rays are used to take a picture of the heart and lungs.
Electrocardiogram (ECG or EKG). The electrical activity of the heart is recorded.
Echocardiogram. Sound waves are used to create a picture of the heart and look for structural defects and other problems.
A PDA may close on its own, without treatment. If it doesn’t, treatment options include cardiac catheterization or surgery. Your child’s cardiologist will evaluate your child’s heart and discuss the best treatment option with you.
Cardiac catheterization. A thin, flexible tube (catheter) is inserted into a blood vessel. It’s used to guide a coil or closing device into the heart to close the PDA. The catheter is removed when the coil or device is in place.
Surgery. Two techniques may be used. In the first (thoracotomy), an incision may be made through the chest between the ribs to reach the PDA. In the second technique, video-assisted thoracoscopic surgery (VATS), very small incisions are made in the chest and a special scope that has a camera on the end is used to guide the surgeon to the PDA. The PDA is clipped or tied off. It may or may not be divided. If it’s divided, the open ends are closed with sutures.
Risks and possible complications include:
Reaction to contrast dye (only with cardiac catheterization)
Reaction to sedative or anesthesia
Incomplete closure of the PDA
Arrhythmia (abnormal heart rhythm)
Injury to the heart or a blood vessel
After surgery or a cardiac catheterization procedure, call the doctor right away if your child has any of the following:
Increased redness, draining, swelling, or bleeding at the incision or insertion site
Fever 100.4°F (38°C) or higher
Shortness of breath
Cough that won’t go away
Prolonged nausea or vomiting
After repair of a PDA, symptoms related to the defect should go away. Your child should have a heart that works normally.
Follow-up visits with the doctor may be needed for 6 months after treatment.
Your child may need to take antibiotics for about 6 months before having any surgery or dental work after PDA closure. This is to prevent infection of the inside lining of the heart or valves. This infection is called infective endocarditis. Antibiotics should be taken as directed by the cardiologist.
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