Persistent patent ductus arteriosus (PDA)
A persistent ductus arteriosus (PDA) is a heart defect in which a blood vessel (the ductus arteriosus) between the aorta and the pulmonary artery remains open. Normally, this blood vessel, which is necessary before birth, closes within hours or a few days after birth. This problem often occurs in immature premature babies. There is an additional blood flow through the pulmonary arteries with a strain on the left ventricle.
Symptoms
In premature babies, a significant PDA leads to the need for ventilation, fluctuations in oxygen saturation in the blood, cardiac insufficiency with drinking and failure to thrive, as well as to an increased risk of typical complications of prematurity.
In infancy and beyond, a PDA can lead to drinking and failure to thrive, stress restriction and, in the late stages, to pulmonary hypertension with bluish colouring of the skin (cyanosis).
Therapy
Depending on the severity (size) of a persistent patent ductus arteriosus (PDA), treatment may be required.
In premature babies, an initial attempt can be made to close the ductus arteriosus with medication.
If this is ineffective, surgical closure via a lateral incision in the left chest may be necessary. After visualisation of the PDA, it is wrapped with a suture or closed with metal clips. This operation is performed without the use of a heart-lung machine
For some years now, even very small premature babies, some weighing less than 1000g, have been offered closure using cardiac catheterisation techniques without surgery. In the vast majority of patients beyond premature babies, a PDA is closed without complications using cardiac catheterisation with various closure systems and only very rarely is surgery necessary.
In rare cases of a PDA with pulmonary hypertension that is diagnosed too late, it can no longer be closed and can only be treated with medication to alleviate the symptoms.
