Before we discuss patent ductus arteriosus (PDA), let’s quickly review how the normal heart functions: the heart is a pumping machine with two sides. The right side pumps blood to the lungs to collect oxygen. The oxygen-rich blood then returns from the lungs to the left side of the heart, which pumps it to the whole body.
Now, what is PDA?
A baby in the womb receives oxygen from the mother’s lungs; therefore, there is no need for the baby’s heart to pump blood to its own lungs. The ductus arteriosus (DA) is a blood vessel, present in all babies in the womb, which allows blood to bypass the lungs. After birth, the baby needs its own lungs for oxygen supply and the DA normally closes within 2-3 weeks. If the DA remains open after three months of life in preterm infants, or after one year of life in full-term infants, the medical condition is known as patent (meaning open) ductus arteriosus, or PDA.
What are the effects of PDA?
- A PDA allows extra blood to flow into the lungs, straining the heart. The larger the PDA, the greater the amount of extra blood that passes through the lungs.
- Increased blood flow through the lungs can also mean reduced blood flow to the rest of the body, causing damage, especially to the intestines and kidneys.
- A PDA can also slightly increase the risk of infective endocarditis (inflammation of the inner tissues of the heart).
What symptoms should I look for, and when?
- Look for faster and heavier breathing, difficulty in feeding, and/or lagging growth.
- If the PDA is large, symptoms may appear after several weeks of birth.
How is PDA diagnosed?
The patient may undergo a few tests, which could include an echo, chest x-ray, magnetic resonance angiogram (MRA), and/or cardiac computed tomography (CT).
What are the treatment options for PDA?
- A small PDA usually closes by itself within a few months of birth, but regular check-ups with a cardiologist are required to monitor the condition.
- Medications are needed to prevent bacterial infections and heart failure.
- A PDA may be surgically closed, either through video-assisted thoracoscopic surgery (VATS), ligation, or posterolateral thoracotomy.
- Non-surgical interventions to close a PDA include cardiac catheterization with a closure device, or transcatheter occlusion.
What can the child do after undergoing surgery for PDA?
- Regularly brush and floss teeth to prevent infections, and attend regular dental check- Dental infections are a common way that an infection that spreads is initially introduced to the body, so dental prophylaxis is essential post-surgery.
- Play and exercise as per the doctor’s advice.
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