The ductus arteriosus, a blood vessel between the pulmonary artery and the aorta, is critical to your baby’s health before birth and can be lifesaving after birth for babies who have hypoplastic left heart syndrome or hypoplastic right ventricle. In utero, the ductus arteriosus lets blood bypass the lungs because the baby is getting oxygen from his mother and isn’t breathing on his own. After birth, the baby begins breathing for himself and the ductus arteriosus closes within a few days. Patent ductus arteriosus is diagnosed when the vessel doesn’t close. An open ductus arteriosus affects how the heart works and can lead to heart problems. With treatment, your child’s symptoms should abate and the heart should function properly.

Wellness & Prevention

Patent ductus arteriosus impacts how efficiently the heart and lungs work to pump and oxygenate blood. An open ductus arteriosus allows blood that has already been oxygenated to circulate back through the lungs and left ventricle, forcing the lungs to handle a higher volume of blood than normal and raises the pressure in the blood vessels. Fluid can accumulate in the lungs as a result, making it difficult for your baby to eat and breathe. PDA can weaken the heart muscle and cause complications, such as infective endocarditis. Severe patent ductus arteriosus can lead to congestive heart failure.

Although the exact cause is unknown, girls and premature babies are more likely to have patent ductus arteriosus. A baby’s risk of PDA may also increase if there is a family history of heart defects and genetic conditions or the mother had rubella during pregnancy. Babies born at altitudes of 10,000 feet or higher may also be at a greater risk of developing patent ductus arteriosus than babies born at lower altitudes.

A small PDA may not cause any symptoms and could go undetected. Symptoms of a large PDA may include:

  • Rapid heart rate
  • Heart murmur
  • Heavy, rapid or congested breathing
  • Fatigue
  • Sweating
  • Poor weight gain
  • Frequent respiratory infections
  • Trouble feeding, disinterest in eating or tiring while feeding

Diagnosis

Your child’s doctor may be the first medical professional to notice patent ductus arteriosus during a physical exam. He may have heard extra noise caused by abnormal blood flow and recommend that your child see a pediatric cardiologist. There are several different ways that cardiologists confirm a diagnosis of patent ductus arteriosus.

  • Chest X-ray: An X-ray allows your pediatric cardiologist to see the size and shape of your child’s heart and lungs. PDA can cause an enlarged heart and changes to the lungs that may be seen on an X-ray.
  • Electrocardiogram (ECG or EKG): An electrocardiogram records the electrical activity in your child’s heart. An ECG shows abnormal heart rhythms, such as a cardiac arrhythmia, and stress on the heart muscle.
  • Echocardiogram: An echocardiogram uses ultrasound technology and an electronic sensor to create a moving image of the heart and heart valves to assess the structure and function of the heart. The test can show how blood is flowing through the PDA, how much blood is passing through the vessel and how large the ductus arteriosus is.
  • Cardiac catheterization: A more invasive procedure, a small catheter is inserted into a larger blood vessel, often in the groin, and guided to the heart where blood pressure and oxygen measurements can be taken in the aorta, pulmonary artery and the four chambers of the heart.

Treatments

If the ductus arteriosus is small, the lungs may be able to accommodate the extra blood and treatment may not be needed. In premature babies, a PDA may close on its own after a longer period of time than normal. If your baby has a small PDA or is premature, your pediatric cardiologist may recommend monitoring your baby’s health closely.

Treatment options for a larger PDA that causes symptoms can include:

  • Medication: A pediatric cardiologist may prescribe IV medication for premature babies to help a patent ductus arteriosus close. Related to aspirin and ibuprofen, indomethacin triggers the muscles in the ductus arteriosus to constrict and close the PDA. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, may also block chemicals in your baby’s body that can keep a PDA open.
  • Cardiac catheterization: A tiny catheter is inserted through a bigger blood vessel and threaded to the heart where your pediatric cardiologist can place a coil or plug in the PDA.
  • Surgery: Your pediatric cardiologist may recommend surgery to repair or close the PDA if earlier treatments were not successful.

Aftercare

After treatment, a premature baby’s prognosis can vary depending on your child’s gestational age and other conditions. Most full-term babies who had early treatment for a PDA have healthy growth, appetite and activity levels. Children who had PDA treatment later or have an unresolved PDA may need ongoing care and monitoring at a pediatric heart center.