Patent ductus arteriosus (PDA) treatment | Dr Samson Olori

What is PDA?

The ductus arteriosus is a blood vessel that in the fetus allows blood to bypass the lungs (because the baby gets oxygen from the mother). After birth, when the baby breathes and the lungs take over, this vessel normally closes within the first hours or days of life. If it stays open (patent), it is called a PDA. Blood then flows from the aorta into the pulmonary artery, overloading the lungs and heart. In premature babies a PDA is more common and can cause breathing difficulty, heart failure, or need for more ventilator support. In full-term babies and older children, a small PDA may cause no symptoms (sometimes found because of a heart murmur); a large PDA can cause fast breathing, poor growth, and recurrent chest infections. Untreated, a significant PDA increases the risk of heart failure and infection of the heart lining (endocarditis).

Treatment options

In newborns, the duct may close on its own; if the baby is stable, the team may wait. In premature babies, medicine (e.g. indomethacin or ibuprofen) is often tried first to encourage the duct to close. If the PDA is large or does not close, or in older infants and children, closure is usually recommended. This can be done by catheter: a device or coil is passed from a vein (often in the groin) to the heart and used to block the duct. Surgery is an option when the PDA is very large, when anatomy is not suitable for a device, or when preferred by the team. Surgery involves a small cut between the ribs; the duct is tied and cut. Risks of either approach are generally low. We can refer you or your child to a cardiologist for assessment and the best option.

Diagnosis and recovery

PDA is often suspected when a doctor hears a characteristic heart murmur. In newborns, symptoms such as fast breathing or heart failure may prompt an echocardiogram to confirm the diagnosis. Chest X-ray and other tests may be used to assess heart size and lung blood flow. After closure (by device or surgery), recovery is usually straightforward: a short stay in hospital, wound care if surgery was done, and follow-up with the cardiologist to confirm the duct is closed and the heart is working well. Long-term outlook after successful closure is excellent. We can refer you or your child to a cardiologist for assessment and the best option.

Frequently asked questions

Can PDA close on its own?
In full-term babies the duct often closes in the first days of life. In premature babies, medicine is often tried first. If the PDA remains significant, closure by device or surgery is usually recommended.
Is PDA closure safe?
Device closure and surgery are well-established and generally safe. Your cardiologist will explain the benefits and risks for your or your child’s situation.
When is it good for the duct to stay open?
In some heart defects (e.g. certain types of pulmonary or aortic obstruction), the duct is needed to supply blood to the lungs or body. In those cases, medicine may be used to keep it open until surgery is done.
How long is recovery after PDA closure?
After catheter closure, many children go home within a day or two. After surgery, a short hospital stay and a few weeks of avoiding strenuous activity are typical. Your cardiologist will give specific advice.