Question: What is (are) Patent Ductus Arteriosus ?
Answer: Patent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. Before birth, the two major arteriesthe aorta and the pulmonary (PULL-mun-ary) arteryare connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation. Within minutes or up to a few days after birth, the vessel is supposed to close as part of the normal changes occurring in the baby's circulation. In some babies, however, the ductus arteriosus remains open (patent). This opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can put strain on the heart and increase blood pressure in the lung arteries. Normal Heart and Heart With Patent Ductus Arteriosus Go to the "How the Heart Works" section of this article for more details about how a normal heart works compared with a heart that has PDA. Overview PDA is a type of congenital (kon-JEN-ih-tal) heart defect. A congenital heart defect is any type of heart problem that's present at birth. If your baby has a PDA but an otherwise normal heart, the PDA may shrink and go away. However, some children need treatment to close their PDAs. Some children who have PDAs are given medicine to keep the ductus arteriosus open. For example, this may be done if a child is born with another heart defect that decreases blood flow to the lungs or the rest of the body. Keeping the PDA open helps maintain blood flow and oxygen levels until doctors can do surgery to correct the other heart defect. Outlook PDA is a fairly common congenital heart defect in the United States. Although the condition can affect full-term infants, it's more common in premature infants. On average, PDA occurs in about 8 out of every 1,000 premature babies, compared with 2out of every 1,000 full-term babies. Premature babies also are more vulnerable to the effects of PDA. PDA is twice as common in girls as it is in boys. Doctors treat the condition with medicines, catheter-based procedures, and surgery. Most children who have PDAs live healthy, normal lives after treatment.
Source: NHLBI

Question: What causes Patent Ductus Arteriosus ?
Answer: If your child has patent ductus arteriosus (PDA), you may think you did something wrong during your pregnancy to cause the problem. However, the cause of patent ductus arteriosus isn't known. Genetics may play a role in causing the condition. A defect in one or more genes might prevent the ductus arteriosus from closing after birth.
Source: NHLBI

Question: Who is at risk for Patent Ductus Arteriosus? ?
Answer: Patent ductus arteriosus (PDA) is a relatively common congenital heart defect in the United States. The condition occurs more often in premature infants (on average, occurring in about 8 of every 1,000 births). However, PDA also occurs in full-term infants (on average, occurring in about 2 of every 1,000 births). PDA also is more common in: Infants who have genetic conditions such as Down syndrome Infants whose mothers had German measles (rubella) during pregnancy PDA is twice as common in girls as it is in boys.
Source: NHLBI

Question: What are the symptoms of Patent Ductus Arteriosus ?
Answer: A heart murmur may be the only sign that a baby has patent ductus arteriosus (PDA). A heart murmur is an extra or unusual sound heard during the heartbeat. Heart murmurs also have other causes besides PDA, and most murmurs are harmless. Some infants may develop signs or symptoms of volume overload on the heart and excess blood flow in the lungs. Signs and symptoms may include: Fast breathing, working hard to breathe, or shortness of breath. Premature infants may need increased oxygen or help breathing from a ventilator. Poor feeding and poor weight gain. Tiring easily. Sweating with exertion, such as while feeding.
Source: NHLBI

Question: What are the treatments for Patent Ductus Arteriosus ?
Answer: Patent ductus arteriosus (PDA) is treated with medicines, catheter-based procedures, and surgery. The goal of treatment is to close the PDA. Closure will help prevent complications and reverse the effects of increased blood volume. Small PDAs often close without treatment. For full-term infants, treatment is needed if the PDA is large or causing health problems. For premature infants, treatment is needed if the PDA is causing breathing problems or heart problems. Talk with your child's doctor about treatment options and how your family prefers to handle treatment decisions. Medicines Your child's doctor may prescribe medicines to help close your child's PDA. Indomethacin (in-doh-METH-ah-sin) is a medicine that helps close PDAs in premature infants. This medicine triggers the PDA to constrict or tighten, which closes the opening. Indomethacin usually doesn't work in full-term infants. Ibuprofen also is used to close PDAs in premature infants. This medicine is similar to indomethacin. Catheter-Based Procedures Catheters are thin, flexible tubes that doctors use as part of a procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun). Catheter-based procedures often are used to close PDAs in infants or children who are large enough to have the procedure. Your child's doctor may refer to the procedure as "transcatheter device closure." The procedure sometimes is used for small PDAs to prevent the risk of infective endocarditis (IE). IE is an infection of the inner lining of the heart chambers and valves. Your child will be given medicine to help him or her relax or sleep during the procedure. The doctor will insert a catheter in a large blood vessel in the groin (upper thigh). He or she will then guide the catheter to your child's heart. A small metal coil or other blocking device is passed through the catheter and placed in the PDA. This device blocks blood flow through the vessel. Catheter-based procedures don't require the child's chest to be opened. They also allow the child to recover quickly. These procedures often are done on an outpatient basis. You'll most likely be able to take your child home the same day the procedure is done. Complications from catheter-based procedures are rare and short term. They can include bleeding, infection, and movement of the blocking device from where it was placed. Surgery Surgery to correct a PDA may be done if: A premature or full-term infant has health problems due to a PDA and is too small to have a catheter-based procedure A catheter-based procedure doesn't successfully close the PDA Surgery is planned for treatment of related congenital heart defects Often, surgery isn't done until after 6 months of age in infants who don't have health problems from their PDAs. Doctors sometimes do surgery on small PDAs to prevent the risk of IE. For the surgery, your child will be given medicine so that he or she will sleep and not feel any pain. The surgeon will make a small incision (cut) between your child's ribs to reach the PDA. He or she will close the PDA using stitches or clips. Complications from surgery are rare and usually short term. They can include hoarseness, a paralyzed diaphragm (the muscle below the lungs), infection, bleeding, or fluid buildup around the lungs. After Surgery After surgery, your child will spend a few days in the hospital. He or she will be given medicine to reduce pain and anxiety. Most children go home 2 days after surgery. Premature infants usually have to stay in the hospital longer because of their other health issues. The doctors and nurses at the hospital will teach you how to care for your child at home. They will talk to you about: Limits on activity for your child while he or she recovers Followup appointments with your child's doctors How to give your child medicines at home, if needed When your child goes home after surgery, you can expect that he or she will feel fairly comfortable. However, you child may have some short-term pain. Your child should begin to eat better and gain weight quickly. Within a few weeks, he or she should fully recover and be able to take part in normal activities. Long-term complications from surgery are rare. However, they can include narrowing of the aorta, incomplete closure of the PDA, and reopening of the PDA.
Source: NHLBI