Patent Ductus Arteriosus

Patent Ductus Arteriosus Patent ductus arteriosus, or PDA, is a congenital heart condition in which there is an irregular transmission of blood between two of the most important arteries in close proximity to the heart. Although the ductus arteriosus normally seals off within a few days, in some newborns, ductus arteriosus remains patent.

A patent ductus arteriosus causes rather forceful blood flow, which makes a sound known as a heart murmur. Listening for this murmur is the most widely used method to screen for heart disease in infants. This murmur is often not noted for several weeks after birth.

In addition to listening to the patient's heart, the physician may notice a bounding pulse, in which the pulse reaches a higher intensity than normal, then quickly disappears.

Unlike many congenital heart defects, a patent ductus arteriosus cannot be diagnosed in utero because it is a normal feature of a developing foetus. Instead, the condition is diagnosed by the presence of symptoms after birth.

How Is Patent Ductus Arteriosus Treated?

Patent ductus arteriosus (PDA) is treated with medicines, catheter-based procedures, and surgery. The goal of treatment is to close the PDA to prevent complications and reverse the effects of increased blood volume to the lungs. Small PDA’s often close without treatment, however, larger ones nearly always need treatment. 

Medicines: Your child's doctor may prescribe medicines to help close your child's PDA.

Catheter-Based Procedures: Catheters are thin, flexible tubes used in a procedure called cardiac catheters. During the procedure, your child will be sedated or given medicine so that he or she will sleep and not feel any discomfort. The doctor will place a catheter in a large blood vessel in the upper thigh (groin) and guide it to your child's heart. A small metal coil or other blocking device is then passed up through the catheter and placed in the PDA to block blood flow through the vessel. Catheter-based procedures don't require the child's chest to be opened. They also let the child recover quickly.

Surgery: Surgery for PDA may be done if:

• A premature or full-term infant develops health problems due to PDA and is too small to have a catheter-based procedure
• A PDA isn't successfully closed by a catheter-based procedure
• Surgery is planned for treatment of other related congenital heart defects

Often, surgery isn't done until after 6 months of age in infants who don't have health problems from their PDA’s. Doctors sometime perform surgery on small PDA’s to prevent the risk of Infection to the heart muscles. For the surgery, your child will be given anesthesia so that he or she will sleep and not feel any discomfort. The surgeon will make a small cut between your child's ribs to reach the PDA. He or she will then close the PDA with stitches or clips.

After Surgery

After surgery, your child will spend a few days in the hospital. He or she will be given medicines to reduce pain and anxiety. Most children go home 2 days after surgery. Premature infants usually have to stay in the hospital longer because of their other health issues.

When your child goes home after surgery, you can expect that he or she will feel fairly comfortable, although there may be some short-term pain. Your child should begin to eat better and gain weight quickly. Within a few weeks, he or she should fully recover and be able to take part in normal activities.

Special Care Units / Diagnostic Equipment / Facilities

• Treadmill Test (TMT)
• Echocardiography (Colour Doppler)
• Stress Echocardiography
• 24 Hour Holter Monitoring
• Ambulatory BP Monitoring
• Stress Thallium Test
• 64 slice CT angiography
• Coronary and peripheral angiograph
• Electrophysiology Study
• Endovascular Suite (For the first time in India)
• Flat Panel Cath Labs with stent boost technology  

Team of Specialists: Cardiology

• Dr. B KalraConsultant- Cardiology at Artemis Health Institute, GurgaonView Profile

• Dr. Niraj KumarConsultant- Interventional Cardiology View Profile

• Dr. KubbaConsultant- CardiologyView Profile