Get answers to your Pediatric Cardiology questions.
The goal of treatment, if the rest of circulation is normal or close to normal, is to close the PDA. In the presence of certain other heart problems, such as hypoplastic left heart syndrome, the PDA may actually be lifesaving and medicine may be used to prevent it from closing.
Sometimes, a PDA may close on its own. Premature babies have a high rate of closure within the first 2 years of life. In full-term infants, a PDA rarely closes on its own after the first few weeks.
When treatment is appropriate, medications such as indomethacin or a special form of ibuprofen are generally the first choice.
If these measures do not work or can't be used, a medical procedure may be needed.
A transcatheter device closure is a minimally invasive procedure that uses a thin, hollow tube. 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. Such endovascular coils have been used successfully as an alternative to surgery.
Surgery may be needed if the catheter procedure does not work or cannot be used. Surgery involves making a small cut between the ribs to repair the PDA.
If a small PDA remains open, heart symptoms may or may not eventually develop. Persons with a moderate or large PDA could eventually develop heart problems unless the PDA is closed.
Closure with medications can work very well in some situations, with few side effects. Early treatment with medications is more likely to be successful.
Surgery carries its own significant risks. It may eliminate some of the problems of a PDA, but it can also introduce a new set of problems. The potential benefits and risks should be weighed carefully before choosing surgery.
If the patent ductus is not closed, the infant has a risk of developing heart failure, pulmonary artery hypertension, or infective endocarditis -- an infection of the inner lining of the heart.
This condition is usually diagnosed by a doctor examining your infant. Breathing and feeding problems in an infant can occasionally be due to an undiagnosed PDA.
Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007.
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