Patent Ductus Arteriosus Repair

Before babies are born, they have a hole near their heart that allows the blood to skip the lungs. This hole is called the ductus arteriosis. When a baby is born, this hole closes and blood goes through the lungs to get oxygenated. This hole usually closes in the first few days of life. If the hole does not close after birth it is called patent ductus arteriosis (PDA).

SYMPTOMS

Having a PDA can also put a person at risk of developing an infection of the lining of the heart (endocarditis) and main arteries. Extra pressure in the blood vessels in the lungs puts more stress on the heart.

RISKS AND COMPLICATIONS

  • Bleeding

  • Damage to the heart chambers or valves

  • Infection where the skin was cut or where the needle entered.

  • Movement of the occluder after placement.

  • Radiation exposure.

  • Fluid in the lungs.

  • Irregular heart rhythms.

  • Death

  • Blood clots in the leg or heart.

  • The PDA does not close all the way or may reopen.

PROCEDURE

Medicines can be used in the first few weeks of life to try to close the PDA. If they do not help, other procedures may be needed. Non-surgical and surgical procedures can be used to close a PDA. These include:

  • Transcatheter occlusion. This is a non-surgical procedure using a long thin tube (transcatheter).

  • The procedure is done by giving medicine that puts the child to sleep (general anesthesia) so your child will have no discomfort.

  • A small needle is put into the blood vessels in the groin. The catheter is passed through the blood vessel and then across the PDA.

  • A tiny device (occluder) is pushed through the catheter and out into the PDA to block it off.

  • Over time, tissue will grow over the occluder and completely seal off the PDA.

  • PDA Ligation. This is a surgical procedure that ties off the PDA.

  • Surgery is done by giving general anesthesia so your child will have no discomfort.

  • Through a small cut (incision) in the side of the chest, the PDA is tied off with a suture or metal clip.

  • Video-Assisted Thoracoscopic Surgery (VATS). Thisis a surgical ligation procedure.

  • Surgery is done by giving general anesthesia so your child will have no discomfort.

  • VATS is performed through 4 small incisions in the chest, without opening the heart. Tools and a video camera are inserted through the incisions to assist with the ligation. Depending on the size of the PDA, 1 or 2 metal clips may be used to close the PDA.

AFTER THE PROCEDURE

  • Your infant will be discharged home within 24 hours after transcatheter occlusion.

  • Your infant will be watched closely in the hospital for a few days after surgical ligation.

  • Follow-up testing such as a chest X-ray and ultrasound of the heart (echocardiogram) will be done to check the results of the procedure.

  • Normal diet and activity may be resumed as directed.

  • Antibiotic medicine is given to prevent endocarditis. This is required for 6 months after PDA closure.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your infant has fever.

  • There is pus, redness or bleeding from the sites.

  • Your infant has trouble breathing or cannot stop coughing.

  • Your infant is not getting better or you are concerned.

  • Your infant has cool feet or legs.

  • Your infant is not wetting the normal amount of diapers.

  • Your infant is vomiting or has abdominal pain.

  • Your infant passes out.