Patent Ductus Arteriosus | Diagnosis and Treatment

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How is patent ductus arteriosus diagnosed?

Patent ductus arteriosis is often first detected when your doctor hears an abnormal heart sound or heart murmur when listening to your baby’s heart.

Depending on the type of murmur your doctor hears, he or she may order further testing such as:

Noah, who had patent ductus arteriosus, with his doctor and his mom

What are the treatment options for patent ductus arteriosus?

A small patent ductus may close on its own as your child grows.

A patent ductus that causes symptoms will require medical management and possibly even surgical repair. Your child's cardiologist will check periodically to see whether the patent ductus is closing on its own.

If a patent ductus does not close on its own, your child may need treatment, such as medication or surgery.

Medication

In premature infants, an intravenous (IV) medication called indomethacin may help close a patent ductus. Indomethacin is related to aspirin and ibuprofen and works by stimulating the muscles inside the patent ductus to constrict, closing the connection. Your child's physician can answer any questions you may have about this treatment.

Catheter-based closure

In many cases your child's patent ductus may be repaired by a cardiac catheterization procedure. During cardiac catheterization, your child is sedated and a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin and guided to the inside of the heart. Once the catheter is in the heart, the cardiologist pass a special device, called a coil or occluder, into the open patent ductus, preventing blood from flowing through it.

Surgical repair

Surgical repair (ligation) is usually recommended for very small or young infants who have a large defect that is causing symptoms. For infants who don’t have any symptoms, the repair may be delayed until the child is bigger.

The goal is to repair the patent ductus arteriosus before the lungs become diseased from too much blood flow and pressure. Your child's cardiologist will recommend when a surgical repair should be performed.

The ligation procedure is performed under general anesthesia. The procedure involves closing the open patent ductus with a clip or suture to prevent the surplus blood from entering your child's lungs. In some cases, robotic surgery equipment is used to correct patent ductus using minimally-invasive surgery techniques.

In some cases, the cardiologist may recommend that your child take antibiotics to prevent bacterial endocarditis after leaving the hospital.

What is the long-term outlook for patent ductus arteriosus?

Most children with a patent ductus will live healthy lives after recovering from the repair. Their activity levels, appetite and growth should return to normal.

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