Patent ductus arteriosus (PDA) is a condition where a temporary blood vessel near an unborn baby's heart, the ductus arteriosus, fails to close after birth. (The blood vessel normally closes after birth because it is no longer needed). The word "patent" means open.

Alternative Names

PDA

Causes, incidence, and risk factors

Before a baby is born, blood flow normally bypasses its lungs because oxygen and nutrients are received from the placenta and the umbilical cord. After birth, when the infant begins to breathe, two structures in the heart -- the foramen ovale and the ductus arteriosus -- close in order to deliver fully oxygenated blood to the body. If the ducts do not close at birth, some of the blood in the left side of the heart will go to the lungs instead of into general circulation. The disorder can occur in both premature and full-term infants. Usually symptoms are mild, but they become more pronounced if not corrected by the age of 2. Risk factors are prematurity and respiratory distress syndrome . The incidence is 1 in 2500-5000 infants.

Signs and tests

A clinician listening to the chest with a stethoscope often hears a heart murmur. The infant may have a bounding pulse . Tests often include:

Treatment

In premature infants, an attempt is made to close the patent ductus by fluid restriction and prostaglandin inhibitors (e.g., indomethacin). Surgical ligation (tying) of the patent ductus is undertaken if these steps do not close the ductus. In full-term infants, surgical ligation of the patent ductus is recommended if heart failure develops. If the infant doesn't have symptoms, the surgery is postponed until 6 months to 3 years of age, unless problems develop. Other treatments include closing the ductus with plugs or coils. These are deployed through catheters placed in arteries in the groin. Intravascular coils are often used for the treating small PDAs.

Expectations (prognosis)

Surgical treatment is associated with a low risk of complications, and the outcome is usually good after surgery.

Complications

If the patent ductus is not closed, the infant has a risk of developing heart failure or infective endocarditis .

Calling your health care provider

This condition is often detected when your health care provider examines your infant. However, if an infant develops shortness of breath or feeds poorly; or other symptoms such as bluish skin ( cyanosis ) occur NOT associated with known PDA, call your health care provider.

Prevention

This condition is not preventable.