Patent ductus arteriosus (PDA) is a condition where there is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a blood vessel that allows blood to go around the baby’s lungs before birth. Soon after the infant is born, the ductus arteriosus is no longer needed since the baby’s lungs fill with air. However, if it remains open, it is referred to as a patent ductus arteriosus.
A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can lead to weakening of the heart muscle and cause heart failure and other complications.
Treatment options for a patent ductus arteriosus include monitoring, taking certain medications, catheterization or open heart surgery.
Patent ductus arteriosus symptoms vary with the size of the defect and whether the baby is full-term or premature. A small PDA might cause no signs or symptoms; however, some infants may have symptoms such as:
· Fast breathing
· Poor eating
· Poor growth
· Sweating while eating
· Fast heart rate
Before birth, the connection between the aorta and pulmonary artery (two major blood vessels leading from the heart) is vital for the baby’s blood circulation. The ductus arteriosus diverts blood from the baby’s lungs while they develop and it obtains oxygen from the mother’s circulation. After birth, if the ductus arteriosus remains open, abnormal blood flow will circulate to the baby’s lungs and heart. Left untreated, the blood pressure in the baby’s lungs might increase, thus weakening its heart, causing heart defects and other more serious complications.
The following include risk factors for having a patent ductus arteriosus:
- Giving birth prematurely
- Having a family history of PDA and other genetic conditions (Ex: Down syndrome)
- Having rubella infection during pregnancy
- Being born at a high altitude (above 10,000 feet)
A small patent ductus arteriosus might not cause complications; however larger defects left untreated could cause:
- Heart infection (endocarditis): Inflammation of the heart’s inner lining
- Pulmonary hypertension: High blood pressure in the lungs (Ex: Eisenmenger syndrome)
- Heart failure
- Pregnancy complications
Treatment options for a patent ductus arteriosus may include the following:
- Close monitoring of the baby’s heart
- The use of nonsteroidal anti-flammatory drugs (NSAIDs) to help close a PDA and block hormone like chemicals in the body that might keep it open
- Catheter procedures: A procedure where a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart where a plug or coil is inserted to close the ductus arteriosus. Possible complications may include: bleeding, infection or movement of the plus placed in the heart
- Open-heart surgery: A procedure where a surgeon makes a small incision between the child’s ribs to reach the child’s heart and repair the open duct using stitches or clips. Possible complications may include: bleeding, infection, hoarseness and a paralyzed diaphragm.
- The use of preventive antibiotics to treat a heart infection (infective endocarditis)
Although there is no sure way of preventing the development of a patent ductus arteriosus in an infant; there are steps that can be taken to ensure a healthy pregnancy. These include:
- Eating a healthy diet
- Exercising regularly
- Quitting smoking while pregnant
- Reducing stress levels
- Stopping birth control
- Updating vaccinations before becoming pregnant to avoid possible infections
- Keeping diabetes under control before and during pregnancy
- Consulting with a genetic counselor about family history of heart defects or other genetic disorders before becoming pregnant