Heart Center: Patent Ductus Arteriosus (PDA)
Before a baby is born, the blood does not pass through the lungs. After the blood leaves the right ventricle and goes out through the pulmonary artery toward the lungs, a small vessel called the Ductus Arteriosus diverts the blood to the aorta to the body. After the baby is born the vessel closes, usually within 24 to 48 hours. If the ductus has not closed by 1 month of age, it rarely closes on its own.
This is called a Patent Ductus Arteriosus (PDA). If the PDA is large enough extra blood flows from the aorta (the area of higher pressure) to the pulmonary artery (the area of lower pressure). This decreases the amount of blood available to the body and increases the blood flow to the lungs beyond what is needed, which can cause congestive heart failure (CHF by increasing the force the right side of the heart has to work against).
However, most PDA's can be closed in the catheterization lab. The procedures are done under general anesthesia and in both the patient is typed and crossmatched for at least one unit of blood (see the page on general information for more about this). During the procedure, a dye injection is done in the aorta to locate and size the PDA. Then a catheter is placed in the PDA and a coil is placed in the PDA. The coil is a small wire that has multiple small pieces of Dacron attached.
After the coil is placed the blood flow across the PDA stops. Eventually the tissue forms around the coil. Although the coil is metal, it is not magnetic and does present a problem with metal detectors or magnets in the future. Occasionally the PDA is so small a wire can be passed through and causes it to spasm and close on its own. Also occasionally the ductus is so large two coils have to be placed to completely close the PDA. There is currently a device in trials that works as a plug for large PDA's.
After the procedure the patient is taken to the recovery room. When they wake up they can drink and then eat when ready. If a device is left in place they stay in the hospital overnight for monitoring and are discharged the next day.
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