Patient
Information
Patent Ductus Arteriosus
What is a PDA?
A patent ductus arteriosus (PDA) is a blood vessel that connects
the main artery to the body (aorta) with the main artery to the
lungs (pulmonary artery). All babies have a PDA before they
are born - it allows the body to send less blood to the lungs,
since babies do not use their lungs before they are born.
After birth, the ductus arteriosus usually closes over the first
days or weeks of life, but in some cases the ductus remains open.
This is a particularly common problem in babies born early
(premature).
Why is it a problem?
If a PDA is large, the result is a
lot of extra blood going to the lungs. Babies may breath
harder and feed less well, and may not gain weight well. In
premature babies, this can result in damage to the lungs, and even
to other organs of the body (since the PDA can "steal" blood from
the body to send to the lungs). A large PDA can also
cause permanent damage to the lungs (pulmonary vascular occlusive
disease).
If a PDA is very small, it may have no important effects on the
way the heart works, but it may still be a problem.
Particularly if the PDA is large enough for a doctor to hear with
a stethoscope, it may be a risk factor for a rare infection called
endocarditis or endarteritis. Because of this risk, it often
makes sense to fix a PDA even if it is very small.
How is it fixed?
There are medicines that can close a PDA in newborns, but these
are not very effective after a baby is a few weeks old. If
the child is older, or the medicines are not effective, a PDA can
be fixed one of several ways. The most often used procedure
is surgery, using an incision that is generally in the left side
between the ribs under the left arm. In some centers on
older children, this surgery can be performed without a large
incision using video-assisted surgical technology (VATS).
More and more frequently, PDAs are closed without surgery using a
catheter (like a very long IV) to deliver a small metal "coil"
into the PDA, closing it from the inside. This procedure is
the least invasive, but it is also the newest.
Patients with small PDAs generally have no restrictions in their
diet or exercise.
For more information about PDAs,
try some of the web links below. I cannot vouch for the contents,
but with the Internet it's always a case of "browser
beware".
American
Heart Association -http://216.185.112.5/presenter.jhtml?identifier=1672
A good site to see a brief description of the different types
of heart disease and the treatments available
University of Wisconsin -
http://www.pediatrics.wisc.edu/childrenshosp/parents_of_preemies/pda.html
PediHeart -
http://www.pediheart.org/parents/defects/PDA.htm
Hendrick Health -
http://www.hendrickhealth.org/healthy/00060070.html
eMedicine -
http://www.emedicine.com/emerg/topic358.htm
More oriented for physicians.
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