Before you begin reading about patent ductus arteriosus, please read the explanation of how the normal heart works for a basic understanding of its structure and function.
View Large Patent Ductus Arteriosus
(PDA) IllustrationBlood flow is different in the fetus and most blood bypasses the lungs. An extra blood vessel (passageway) called the ductus arteriosus (DA) allows blood from the right side of the heart to flow to the aorta, one of the largest arteries, and back out into the body without going through the lungs.
After the baby is born and begins to breathe, the flow of blood changes to include the lungs. The pulmonary artery opens to carry blood from the right side of the heart to the lungs, and the DA is supposed to close.
Patent ductus arteriosus (PDA) is a condition in which the ductus arteriosus doesn't close. Patent means "open." Sometimes the open passageway is wide (a large PDA) and sometimes it is narrow (a small PDA). A large PDA is dangerous because blood flow to the lungs isn't as controlled as it should be, leading to problems with the lungs and heart.
PDA is most common in premature infants.
Symptoms vary depending on the size of the PDA, and include:
Neonatologists, doctors who care for premature babies, work with the Cardiac Center doctors at CHOP to diagnose and treat PDA in newborns. Older infants and children with PDAs are most often sent to our Center after their primary care physicians notice a heart murmur.
Diagnosis of patent ductus arteriosus may require:
If the PDA is not life-threatening, doctors might wait until the child is 1 or 2 years old before recommending treatment. Small PDAs often close on their own.
In premature babies in whom the condition may be dangerous, doctors immediately give medicines to help close the PDA.
If the PDA does not close or narrow significantly in response to medicine, an interventional procedure may be necessary. In most cases, the PDA can be closed through cardiac catheterization. Doctors insert a thin tube (catheter) through a vein and/or artery in the leg, guide it to the heart, and insert a tiny device to block the PDA. In more complex cases surgery may be required. Our cardiothoracic surgeons use stitches or clips to close the PDA.
Learn about "Duct Busters," our traveling cardiothoracic surgical team who perform on-site repairs at other hospitals for PDA in infants too fragile to transport to CHOP.
Once a PDA is closed, no long-term follow-up care is necessary unless there are other cardiac concerns.
Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.
Reviewed by: Matthew Gillespie, MD
Date: October 2008
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