Patent ductus arteriosus

Alternative names
PDA

Definition

Patent ductus arteriosus (PDA) is a condition where the ductus arteriosus, a blood vessel that allows blood to bypass the baby’s lungs before birth, fails to close after birth. The word “patent” means open.

Prior to birth, bloodflow in the fetus bypasses its lungs because the fetus gets oxygen through the placenta. After birth, the ductus arteriosus and foramen ovale close because blood must then go to the infant’s lungs.

Causes, incidence, and risk factors

PDA occurs in about 1 in 2,000 infants. Premature infants and those with respiratory distress syndrome are at higher risk. PDA is also associated with coarctation of the aorta, transposition of the great vessels, and Ventricular septal defect.

Symptoms

Note: There may be no symptoms.

Signs and tests

Patients with PDA have a characteristic Heart Murmur that can be heart with a stethoscope. The diagnosis is confirmed with an echocardiogram.

Treatment

In newborns, fluid restriction and medications (indomethacin, ibuprofen) are used initially to close PDAs. If these measures do not work or can’t be used, surgical ligation (clipping) is performed.

Surgical treatment of PDAs is performed on older children even if they have no symptoms because the PDA will not close by itself. Endovascular coils placed in the PDA have been used successfully as an alternative to surgery.

Expectations (prognosis)

The surgery has a low risk of complications in experienced hands, and the outcome is mostly related to the patient’s pre-existing medical condition(s).

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 usually diagnosed by a doctor examining your infant. Respiratory distress and feeding intolerance in an infant can occasionally be due to undiagnosed PDA.

Prevention
This condition is not preventable.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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