Patent Ductus Arteriosus (PDA)
What is it?
Patent Ductus Arteriosus (PDA) is a heart defect that
occurs shortly after birth. PDA occurs when the ductus
arteriosus (DA) fails to closes, allowing blood to
inappropriately flow from the aorta into the pulmonary
(lung) artery.
Who gets it?
PDA occurs in about 65% of infants who are born at less
than 30 weeks of gestation. In infants who are born at 30
weeks of gestation or more, the incidence of PDA is about
11%.
What causes it?
Normally, the DA channel closes within 3 days after
birth. When this fails to happen, some of the blood that
should have gone through the aorta and on to the rest of
the body is returned through the PDA to the lungs. This
causes the heart to work harder trying to supply enough
blood to the body. The defect is quite common in premature
infants, however the cause of the defect in full-term
babies is unknown.
What are the symptoms?
Infants who have a small open channel often will have
no symptoms except a heart murmur. If the PDA is large, an
infant may have difficulty gaining weight and become short
of breath and sweat when they exert themselves (such as
when they cry). Older children may not be able to exercise
as much as normal and may have frequent lung infections.
How is it diagnosed?
Most PDAs are diagnosed when a doctor detects a heart
murmur with a stethoscope. Some PDAs are silent, however.
An echocardiogram, a special test that uses sound waves to
create a picture of the heart, will often reveal a PDA. A
chest x-ray may also be used to detect an increased amount
of blood in the lungs.
What is the treatment?
In premature infants, a PDA often closes by itself
within weeks or months. In full-term infants or in
premature infants whose PDA fails to close, surgery is
needed, though it is usually delayed until the child is
old enough to tolerate surgery. There are three common
ways to close a PDA surgically. In the first, the surgeon
makes a small cut under the armpit, the ribs are spread
and the surgeon ties off the PDA. In thoracoscopic
surgery, two or three small tubes are inserted in the
baby's side, through which small instruments are used to
tie off the PDA. In the third prodedure, cardiac
catheterization, tubes are inserted in a leg artery and
pushed through to the PDA. Special coils are then inserted
into the PDA that keep blood from flowing into it.
Self-care tips
Treatment of a PDA involves little risk, corrects the
problem, and enables the child to grow and develop
normally. A child in need of surgery to treat a PDA needs
to be carefully monitored until old enough to tolerate
surgery.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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