Once the coil or device is in the correct position, it will be released from the catheter. Then the catheter will be removed Typically this method is used if a child:. Surgery can close PDAs. Surgical closure is often advised for babies younger than 6 months who have large defects and symptoms such as poor weight gain and fast breathing. For babies who don't have symptoms, any surgery may be delayed until after age 6 to 12 months.
Your child's cardiologist will advise when the surgery should be done. It is done under general anesthesia so you child will be asleep. Surgery closes the PDA with stitches or clips. This stops the extra blood from getting into the lungs. Premature babies must have this surgery. If not treated, PDA may lead to long-term lung damage.
It can also damage the blood vessels in the lungs. But this is not common because most children will have been treated for their PDA before the lungs and blood vessels get damaged. If your baby is discharged home before having a repair procedure, you will be shown how to feed and give medicine to your baby. You will also be taught what symptoms to report to your child's healthcare provider.
When your child is discharged after the PDA repair, you may give pain medicine such as acetaminophen or ibuprofen to keep your child comfortable. Your child's cardiac team will talk about pain control before your child goes home. Often infants who fed poorly before surgery have more energy once they recover. They begin to eat better and gain weight faster.
Within a few weeks after surgery, older children are often fully recovered and able to do normal activities. In premature infants, the outlook after PDA surgical repair depends on gestational age and overall health. In children born full-term, early diagnosis and repair of PDA lets them live normal, healthy lives.
Activity levels, appetite, and growth should return to normal. Your child's cardiologist may advise that your child take antibiotics to prevent infection in the heart lining and valves bacterial endocarditis. In children with large PDAs diagnosed very late or never repaired, the outlook is uncertain.
They are at risk for increased blood pressure in the blood vessels of the lungs pulmonary hypertension. These children should get follow-up at a care center that specializes in congenital heart disease.
Call your child's healthcare provider if your child's symptoms get worse, or if new symptoms develop, particularly breathing or feeding problems. It occurs because a normal fetal connection between the aorta and the pulmonary artery does not close as it should after birth. The ductus arteriosus is a normal fetal artery connecting the main body artery aorta and the main lung artery pulmonary artery.
The ductus allows blood to detour away from the lungs before birth. Every baby is born with a ductus arteriosus. After birth, the opening is no longer needed and it usually narrows and closes within the first few days. Sometimes, the ductus doesn't close after birth. Failure of the ductus to close is common in premature infants but rare in full-term babies. In most children, the cause of PDA isn't known. Some children can have other heart defects along with the PDA.
Normally the heart's left side only pumps blood to the body, and the right side only pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the body artery aorta into the lung pulmonary arteries. If the PDA is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested.
If the PDA is small, it won't cause symptoms because the heart and lungs don't have to work harder. The only abnormal finding may be a distinctive type of murmur noise heard with a stethoscope. If the PDA is large, the child may breathe faster and harder than normal. Infants may have trouble feeding and growing at a normal rate. Symptoms may not occur until several weeks after birth. High pressure may occur in the blood vessels in the lungs because more blood than normal is being pumped there.
Over time this may cause permanent damage to the lung blood vessels. If the PDA ductus is small, it doesn't make the heart and lungs work harder. Surgery and other treatments may not be needed. Small PDAs often close on their own within the first few months of life. Most children can have the PDA closed by inserting catheters long thin tubes into the blood vessels in the leg to reach the heart and the PDA, and a coil or other device can be inserted through the catheters into the PDA like a plug.
The figure below on the left shows one example of how a catheterization is used to close the ductus. If surgery is needed, an incision is made in the left side of the chest, between the ribs. The ductus is closed by tying it with suture thread-like material or by permanently placing a small metal clip around the ductus to squeeze it closed.
When a newborn breathes and begins to use the lungs, the ductus is no longer needed and usually closes by itself during the first 2 days after birth. If the ductus doesn't close, the result is a patent meaning "open" ductus arteriosus.
The PDA lets oxygen-rich blood blood high in oxygen from the aorta mix with oxygen-poor blood blood low in oxygen in the pulmonary artery. As a result, too much blood flows into the lungs, which puts a strain on the heart and increases blood pressure in the pulmonary arteries.
In infants born with other heart problems that decrease blood flow from the heart to the lungs or decrease the flow of oxygen-rich blood to the body, the PDA may actually help, and the doctor might prescribe medicine to keep the ductus arteriosus open. The cause of PDA is not known, but genetics might play a role. PDA is more common in premature babies and affects twice as many girls as boys.
It's also common among babies with neonatal respiratory distress syndrome, babies with genetic disorders such as Down syndrome , and babies whose mothers had rubella also called German measles during pregnancy. Untreated, the blood pressure in the baby's lungs might increase pulmonary hypertension and the baby's heart might enlarge and weaken.
A small patent ductus arteriosus might not cause complications. Larger, untreated defects could cause:. Most women who have a small patent ductus arteriosus can tolerate pregnancy without problems.
However, having a larger defect or complications — such as heart failure, arrhythmias or pulmonary hypertension — can increase the risk of complications during pregnancy. If you have Eisenmenger syndrome, pregnancy should be avoided as it can be life-threatening. If you have a heart defect, repaired or not, discuss family planning with your doctor. In some cases, preconception consultations with doctors who specialize in congenital cardiology, genetics and high-risk obstetric care are needed.
Some heart medications can cause serious problems for a developing baby, and it might be necessary to stop or adjust the medications before you become pregnant.
There's no sure way to prevent having a baby with a patent ductus arteriosus. However, it's important to do everything possible to have a healthy pregnancy.
Here are some of the basics:. If you have a family history of heart defects or other genetic disorders, consider talking with a genetic counselor before becoming pregnant.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Patent ductus arteriosus Open pop-up dialog box Close.
Patent ductus arteriosus Patent ductus arterious, shown in the heart on the right, is an abnormal opening between the aorta and the pulmonary artery.
0コメント