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Patent ductus arteriosus, or PDA, is a heart defect that can develop soon after birth. It affects the way blood flows through a baby’s lungs. Mild PDA might not need treatment, but some children with the defect may require catheterization or surgery. Pediatric cardiologist John Thomson of the Blalock-Taussig-Thomas Pediatric and Congenital Heart Center describes what you should know additionally about PDA. What is patent ductus arteriosus?PDA occurs when the opening between the aorta (the artery that carries oxygen-rich blood to the body) and the pulmonary artery (the artery that carries oxygen-poor blood to the lungs) does not close as it should. How does patent ductus arteriosus affect blood flow?PDA causes too much blood to flow into babies’ lungs. While a baby develops in the womb, an opening between the aorta and pulmonary artery (the ductus arteriosus) allows blood to bypass the baby’s lungs and go straight to the body. Blood does not need to go to the lungs first, because the mother supplies the baby with oxygenated blood through the placenta. The ductus arteriosus should close on its own within a few days after birth. When the opening does not close, this connection between arteries is considered a patent, or open, ductus arteriosus. Small connections may not cause problems, but larger connections can cause a range of symptoms and require closure. Patent Ductus Arteriosus CausesExperts aren’t sure exactly what causes PDA. It is much more common in premature infants (babies born more than three weeks before the projected due date). Studies suggest PDA affects about 65% of infants born before the 28th week of pregnancy. It is rare in full-term babies and is twice as common in girls than in boys. Sometimes PDA occurs with other heart defects. The risk of congenital heart defects like PDA may also increase due to:
Patent Ductus Arteriosus SymptomsSymptoms of PDA depend on the size of the opening between a baby’s aorta and pulmonary artery. If the opening is small, your baby may not have symptoms. But a larger opening may cause symptoms such as:
Patent Ductus Arteriosus DiagnosisA health care provider may notice the signs of PDA soon after birth. During a physical exam, they listen for a heart murmur or congestion in the lungs. They also check the baby’s pulse rate and blood pressure. Other tests for PDA help identify signs of the hole and may include: Patent Ductus Arteriosus TreatmentIf a small PDA does not cause severe symptoms, it may not need treatment. Sometimes the connection may close on its own a few months after birth. A baby may need medicine such as indomethacin (an anti-inflammatory) during these months to help close the connection, or water medicine (diuretics) to reduce the risk of fluid buildup. Larger connections usually need treatment with catheterization or surgery. Cardiac catheterizationCatheterization is the most common treatment for PDA. During this minimally invasive procedure, a pediatric interventional cardiologist:
Patent ductus arteriosus surgeryPatent ductus arteriosus surgery is usually reserved for babies with very large PDAs. Open surgery presents more risks than cardiac catheterization and requires a longer recovery time. During this procedure, a pediatric heart surgeon:
Left untreated, PDA may cause complications such as: Living with patent ductus arteriosusThe outlook for children who receive PDA treatment and have no other heart conditions is excellent. Most children go on to lead full, healthy lives with no restrictions on activities. They may need periodic checkups with their pediatric cardiologist to make sure no other heart or lung problems have developed. People who had PDA treatment as an infant or child should seek care from an adult congenital heart specialist as they transition into adulthood. In very rare cases, a second surgery may be necessary if the hole opens up again.
Patent ductus arteriosus (PDA) causes problems with blood flow between the heart and lungs. Patent ductus arteriosus (PDA) is a heart condition in babies. It happens when a blood vessel called the ductus arteriosus doesn’t close as it should after birth. What does the ductus arteriosus do?During fetal development (before a baby is born), very little blood flows to a baby’s lungs. Instead, most of the blood bypasses the baby’s lungs. One way for this to happen is that blood flows from the main heart artery (aorta) to the primary lung artery (pulmonary arteries) through a special fetal blood vessel (ductus arteriosus). This blood vessel usually closes during the baby’s first few days of life when the blood flows to the baby’s lungs. What happens in babies with patent ductus arteriosus?When a baby has a PDA, the ductus arteriosus doesn’t close properly. A small opening is left. The opening allows extra blood from the aorta to enter the baby’s lung arteries. Depending on the size of this blood vessel, your baby’s heart and lungs may have to work harder to pump blood. Who does PDA affect?Babies born prematurely are more likely to have a PDA. The condition is also more common in girls than boys. How common is PDA?Patent ductus arteriosus is the most common heart condition in newborns. Healthcare providers diagnose the condition more often in premature babies. The risk increases the earlier the baby is born. PDA happens in about:
How does PDA affect my baby?A moderate or large PDA can cause babies to breathe faster and harder than normal, as their bodies try to keep up with the extra blood in their lung arteries. If left untreated for a prolonged period, a PDA can lead to the development of pulmonary hypertension (high blood pressure in the lungs) and blood vessel damage.
Researchers don’t know for sure why this condition happens. Patent ductus arteriosus causes may include genetic disorders or a family history of the condition. Other PDA causes may include:
What are patent ductus arteriosus symptoms?PDA symptoms vary according to patent ductus arteriosus types. Small PDAs may not cause any symptoms other than a heart murmur. Larger PDAs may cause:
If you notice symptoms of a PDA in your baby, tell your healthcare provider. Your provider may hear a patent ductus arteriosus heart murmur during a well-baby care visit or physical examination. What tests do providers use to diagnose patent ductus arteriosus?If your healthcare provider suspects PDA, they may recommend referral to a specialist, a pediatric cardiologist. The pediatric cardiologist may order certain tests, including:
Do healthcare providers diagnose PDA in adults?Healthcare providers sometimes diagnose PDA in adults. If you had a small PDA as a baby, you may not have gotten treatment. Symptoms can include:
Your healthcare provider will consider your baby’s age, size and health when determining a treatment plan. They might recommend observation (watchful waiting) to see if the PDA will close on its own. A watchful waiting approach involves regular checkups and tests so the provider can see if the PDA is closing. Occasionally, treatment may not be necessary. What medications do providers use to treat PDA?Healthcare providers may treat patent ductus arteriosus with medication, including nonsteroidal anti-inflammatory drugs (NSAIDs). Medications may encourage patent ductus arteriosus closure. This is commonly used in premature babies, but not in older children or adults. What are other types of patent ductus arteriosus treatment?Healthcare providers may treat PDA with surgical procedures, including:
How soon after treatment will blood flow return to normal?After catheterization or surgery, blood flow returns to normal immediately if there are no other heart defects. Are there other complications from PDA?Closing the PDA gets blood flow back to normal. After closure via a cardiac catheterization, your child will take antibiotics for six months to prevent heart infection (endocarditis). Your healthcare provider will discuss the necessary follow-up care with you. Adults who have PDA closure procedures will also take antibiotics for six months and should see a cardiologist for follow-up care.
There isn’t anything you can do to prevent PDA. Are there conditions that put my baby at higher risk for PDA?If you have rubella during pregnancy, your baby may be at higher risk of developing PDA. Tell your healthcare provider right away if you’re exposed to rubella during pregnancy.
With treatment, most babies born with PDA live healthy and active lives. Is patent ductus arteriosus curable?If PDA doesn’t close on its own, healthcare providers can correct it, if needed. Babies and children with moderate and large sized PDA’s that are not treated in the correct timeframe may be at higher risk for developing heart complications as adults. Talk with your healthcare provider about whether your baby needs follow-up care.
Follow all instructions from your healthcare provider. Keep all follow-up appointments and let your provider know right away if your baby develops new symptoms. When should I call my healthcare provider?Call your provider if your baby develops new symptoms. If your baby has trouble breathing, seek emergency care right away. A note from Cleveland Clinic Patent ductus arteriosus (PDA) is a congenital heart condition. With treatment, your child can live an active and healthy life. Talk with your healthcare provider about the best treatment options.
Last reviewed by a Cleveland Clinic medical professional on 04/25/2022. References
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