Normal heart

Normal Heart

PDA

What is a PDA (Patent ductus arteriosus) ?

A PDA is a tube connecting the 2 large blood vessels leaving the heart (the aorta and the pulmonary artery). Everyone has a PDA during fetal life in the womb. In most babies the PDA closes in the first few days of life. In some cases, particularly premature babies they may not close naturally.

Symptoms

Some babies and children will have no symptoms. Those with larger defects may become breathless, tire more easily, have slower weight gain with feeding difficulties and be more prone to respiratory infections. Premature babies with a PDA may have difficulty weaning of respiratory ventilatory support.

Diagnosis

A clinical examination will usually reveal a heart murmur. An echocardiogram will diagnose an PDA. An ECG will also be performed and often a chest X-ray.

Treatment

  • Very small PDAs especially those without a heart murmur (silent ducts) require no treatment. Some may even spontaneously close as the child grows. Larger ones may require treatment. The treatment approach depends on the size and shape of the PDA and symptoms.
  • Premature babies early in life may be given indomethacin/ibuprofen or paracetamol in an attempt to close the PDA. This is not routinely given after the first few weeks of life.
  • Some babies may initially require treatment with liquid medicines called diuretics, which make the work of the heart easier.
  • Definitive PDA closure is most commonly performed using a keyhole approach (via an interventional cardiac catheter) which places a permanent device in the PDA via a tube which is passed to the heart from a vein in the leg. PDA closure devices are often plugs or coils and are made of a special mesh of a metal alloy (nitinol).
  • Under certain circumstances surgical ligation of the PDA is recommended.
Dr Naqvi works with an outstanding well-respected team of NICOR audited congenital cardiac interventionalists and surgeons, and if needed, will refer your child to the one who is best for your child’s heart.

Prognosis

The outlook for children with an isolated patent ductus arteriosus is usually excellent. Dr Naqvi has cared for many babies and children with PDAs. She says “Having a PDA early in life does not stop children doing well in sports or from having a full, active long life.”
Interestingly PDAs are also seen in animals including dogs and cats. They are treated in a similar way by vets. They are commonest in poodles, Chihuahuas and German Shepherds.
For more information about PDA please see the following links:
The British Heart Foundation
The American Heart Association
The Children’s Heart Federation
Disclaimer: The opinions and facts shown in this article are as accurate and up to date as possible, but are provided as general “information resources”, which may not be relevant to individual persons. This article is not a substitute for individual assessment and always take advice from a paediatric cardiologist who is familiar with the particular person.