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://220.127.116.11/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.