Patent Ductus Arteriosus

What is patent ductus arteriosus?

Patent ductus arteriosus is a congenital heart condition where there is a persistent connection between the pulmonary artery and the aorta. This causes blood to mix between the two arteries and forces the heart and lungs to work harder.

Patent ductus is the sixth most common congenital heart defect. It occurs in 5 to 10 percent of all children born with congenital heart disease. Patent ductus occurs twice as often in girls as in boys.

Almost all babies are born with a small connection between the pulmonary artery and aorta, called the ductus arteriosus. During pregnancy, this opening is necessary to allow oxygen-rich (red) blood to bypass the baby's lungs and flow into the body. In most cases, the ductus arteriosus closes naturally after birth.


In babies with patent ductus, the ductus arteriosus remains open (patent). This allows the oxygen-rich (red) blood to mix with oxygen-poor (blue) blood and forces the lungs and heart to handle a larger amount of blood than is normal.w

How well the lung vessels can compensate depends on how big the patent ductus is and how much blood from the aorta is able to pass through it. Extra blood flow may cause in higher pressure in the blood vessels of the lungs, a condition called pulmonary hypertension. The larger the volume of blood that goes to the lungs, the more potential damage to the lungs and heart.

Also, because blood is pumped at high pressure through the patent ductus, the lining of the pulmonary artery may become irritated and inflamed. Bacteria in the bloodstream can easily infect this injured area, causing a serious illness known as bacterial endocarditis.

The extra blood that flows to the lungs through the patent ductus increases the workload of the heart and can lead to heart failure.

What are the symptoms of patent ductus arteriosus?

The size of the patent ductus arteriosus will affect the type of symptoms, the severity of symptoms and when they occur.

A child with a small patent ductus might not have any symptoms, and your child's doctor may only discover the defect by hearing a heart murmur.

Babies with a larger patent ductus may have the following symptoms:

  • fatigue
  • sweating
  • rapid breathing
  • heavy breathing
  • congested breathing
  • disinterest in feeding or tiring while feeding
  • poor weight gain

What are the causes of patent ductus arteriosus?

Almost all children have a small connection between the aorta and pulmonary artery at birth. It is not known why some children have a connection that doesn’t close.

How we care for patent ductus arteriosus

Our approach to the treatment of patent ductus at the Boston Children's Hospital Benderson Family Heart Center is a carefully coordinated approach by multiple specialties. We offer treatments, including medical therapy, minimally invasive catheter-based interventions, and minimally invasive surgical solutions.

Our areas of innovation for patent ductus arteriosus

Boston Children's is home to the nation's most intensive clinical and basic research program focused on pediatric heart disease. A world leader in opening new avenues of "translational research," our research team is focused on bringing laboratory advances to patients as quickly as possible.

Boston Children's has pioneered interventional catheterization repair of many types of congenital heart defects, including patent ductus arteriosus. In many cases, this eliminates the need for open-heart surgery, allowing less pain, reduced chance of infection, and shorter recovery time.