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Pediatric Patent Ductus Arteriosus (PDA)

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Summary

Pediatric patent ductus arteriosus (PDA) is an opening between the two large blood vessels that go to the heart and lungs (ductus arteriosus).

Expanded overview

The ductus arteriosus is a naturally occurring connection between the two large blood vessels that go to the heart and lungs. Typically, the connection closes during development. Congenital (present at birth) PDA occurs when a baby is born with an open (patent) connection.

When healthy, the heart cycles blood to and from the lungs and out into the body, using a series of "one-way streets" called valves. PDA allows oxygen-rich blood back into the lungs rather than circulating out properly to the body. This causes the muscle to work harder, which can lead to heart and lung damage.

Symptoms

Children with a small PDA may not experience any symptoms, or the symptoms may go unnoticed until adulthood. Typically experienced during infancy (birth to 1 year*), symptoms can vary depending on the size of the opening, and if the baby is full-term or premature.

Symptoms can include:

  • Poor eating, which leads to poor growth
  • Sweating with crying or eating
  • Persistent fast breathing or breathlessness
  • Easy tiring
  • Rapid heart rate
  • Congested breathing
  • Lung infections

The symptoms of PDA may look like other medical conditions and heart problems. If you notice any of these signs in your child, it’s important to see a doctor right away.

Tests and Diagnosis

Accurately diagnosing PDA helps us make sure your child gets the treatment he or she needs as quickly as possible. We start with a comprehensive exam, which may include one or more separate tests.

Your child’s physical evaluation may include:

  • Questions about growth, development, family history and any recent illnesses
  • Listening to the heart and lungs
  • Observing symptoms

Diagnostic testing may include:

  • Chest X-ray
  • Electrocardiogram (EKG)
  • Echocardiogram

With expertise in every aspect of pediatric heart disease, Children’s Health℠ offers comprehensive pediatric heart care. Learn more about the full range of tests we offer in our cardiac imaging department.

Causes

Normally a patent ductus closes shortly after birth. In some children, the connection does not close. Although the exact reasons why this happens in some babies and not others is not known. It is more common in babies born prematurely

Treatments

Treating PDA often involves surgically closing the ductus arteriosus. In some cases, we use temporary treatments while we wait to see if the connection closes on its own. In older infants and children, we can close the connection using a catheter-based procedure.

Treatments for PDA include:

  • Medical management: Babies born prematurely may receive an intravenous (IV) medication called indomethacin to help the PDA close on its own.
  • Nutrition: Premature babies and children with a large PDA may receive special formula or breast milk supplements to help them get enough nutrition to gain weight.
  • Surgery: If other treatments aren’t working, your child may need surgery. In most cases, we perform PDA closure with minimally invasive techniques that use tiny incisions.
  • Device treatment: We place small coils or plugs in the PDA using a catheter that goes through a small incision in the leg.

Learn more about our cardiac catheterization and intervention program.

Frequently Asked Questions

Why is PDA a concern?

When the ductus arteriosus stays open, oxygen-rich blood mixes with oxygen-poor blood. This causes the blood vessels in the lungs to handle a larger amount of blood than normal. Over time, this extra blood flow can cause lung damage and an enlarged heart.

Will my child be able to live a normal life?

Children with repaired (closed) PDAs normally go on to live normal, healthy lives. Your child’s activity levels, appetite and growth should return to normal after they recover from surgery.

What happens after PDA closure surgery?

Your child will need a few days to recover, usually at home. In some cases, your child may need to take antibiotics to prevent infection.

Resources

*Age limit of infants defined by the World Health Organization (WHO).

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