Patent Ductus Arteriosus

Signs and Symptoms

Most children with patent ductus arteriosus (PDA) don't have obvious symptoms unless congestive heart failure develops. PDA symptoms associated with congestive heart failure include rapid breathing, feeding difficulties and cold sweat.

Diagnosis

To diagnose patent ductus arteriosis (PDA), your doctor will conduct a thorough medical exam. Most children with PDA have a distinctive heart murmur, which can be easily detected by a doctor. Tests may be performed to make a definite diagnosis and rule out other conditions that cause heart murmurs. These may include:

• Chest X-ray to see the heart's size
• Echocardiogram, a test that uses sound waves to create a moving picture of the heart.
• Electrocardiogram (ECG or EKG), a test that records the electrical activity of the heart.

Treatment

Small patent ductus arteriosis (PDA) often close over time and only require anti-infection medications. If the PDA is large, congestive heart failure may develop and other medications may be needed. In newborns, a drug called Indomethacin may be given to help close the PDA.

If a PDA remains open when your child is 1 to 2 years of age or if congestive heart failure doesn't respond to medication, the opening must be closed by surgery or a less invasive procedure that uses catheters and special metal coils or plugs.

Catheter Procedure — Long, flexible, narrow tubes called catheters are inserted through a tiny incision into the large blood vessels in the legs. The tubes are directed through the blood vessels to the heart. Once in the heart, the catheters are used as conduits to place small metal coils or plugs in the ductus vessel. The coil or plug blocks blood flow through the ductus and is covered completely by the lining of the blood vessel. This procedure takes about three hours and is performed in our Cardiac Catheterization Laboratory. In most cases, patients are discharged from the hospital the same day as the procedure.

Surgery — Surgery may be necessary if the PDA is large or the baby is very young. A small incision is made on the left side of the chest between the ribs. The ductus is either tied off or divided. The surgery usually requires a hospital stay of several days for recovery.