Treatments for patent ductus arteriosus depend on the age of the person being treated.
- Watchful waiting. In a premature baby, the patent ductus arteriosus often closes on its own eventually. Doctors will monitor your baby's heart during those weeks to make sure the open blood vessel is closing properly. For full-term babies, children and adults who have a small PDA that's not causing other health problems, it's possible your doctor will recommend monitoring the condition and not having any other procedures to close the PDA.
- Medications. For premature babies, it's possible your baby's doctors may use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or indomethacin (Indocin), to help close a PDA. NSAIDs block the hormone-like chemicals in the body that keep the PDA open. NSAIDs won't close a PDA in full-term babies, children or adults. Recent research has found that paracetamol — commonly known as acetaminophen (Tylenol, others) in the U.S. — also may be effective in helping to close PDAs, but more research is needed to confirm this finding.
Open-heart surgery. If medications haven't closed the PDA, and your baby's condition has caused health problems, open-heart surgery may be recommended.
During the surgery, a surgeon will make a small cut between your child's ribs to reach your child's heart and repair the open duct using stitches or clips. After the surgery, your child will remain in the hospital for several days for observation. It usually takes a few weeks for your child to fully recover. Open-heart surgery may also be recommended for adults who have a PDA that's causing health problems. Possible risks include bleeding, infection, a paralyzed diaphragm and hoarseness.
Catheter procedures. Catheter procedures, which are less invasive than open-heart surgeries, aren't an immediate option for premature babies because they are too small. However, if your baby doesn't have any health problems related to his or her PDA, your baby's doctor may recommend waiting until your baby is about a year old to perform a catheter procedure to correct the PDA. After a year, a PDA generally won't close on its own. Catheter procedures tend to have fewer complications and a shorter recovery time than do open-heart surgeries. Catheter procedures can also be used to treat full-term babies, children and adults.
In a catheter procedure, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil is inserted to close the ductus arteriosus.
This procedure might be done on an outpatient basis, meaning your child probably wouldn't need to stay overnight in the hospital. Complications from catheter procedures include bleeding, infection, or movement of the plug or coil from where it was placed in the heart.
In the past, people who've had a PDA were advised to take antibiotics before dental work and certain types of surgical procedures to prevent an infection of the heart (infective endocarditis).
Preventive antibiotics are no longer recommended for most people with a patent ductus arteriosus. However, some people still need antibiotics, such as those who:
- Have other heart conditions or artificial valves
- Have a large defect that's causing a low blood oxygen level
- Have had a heart valve repaired with artificial material
If you've ever been told that you or your child needs to take antibiotics before any procedures, talk with your doctor about whether antibiotics are truly needed.
Dec. 22, 2011
- Patent ductus arteriosus. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pda/. Accessed Nov. 9, 2011.
- Patent ductus arteriosus. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pediatrics/congenital_cardiovascular_anomalies/patent_ductus_arteriosus_pda.html?qt=patent%20ductus%20arteriosus&alt=sh. Accessed Nov. 9, 2011.
- Schneider DJ, et al. Patent ductus arteriosus. Circulation. 2006;114:1873.
- Doyle T, et al. Clinical manifestations and diagnosis of patent ductus arteriosus. http://www.uptodate.com/home/index.html. Accessed Nov. 9, 2011.
- Phillips III JB, et al. Pathophysiology, clinical manifestations, and diagnosis of patent ductus arteriosus in premature infants. http://www.uptodate.com/home/index.html Accessed Nov. 9, 2011.
- Miyamoto SD, et al. Cardiovascular diseases. In: Hay WW, et al, eds. Current Diagnosis & Treatment: Pediatrics. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6582787. Accessed November 13, 2011.
- Patent ductus arteriosus (PDA). American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Patent-Ductus-Arteriosis-PDA_UCM_307032_Article.jsp#.Trsm4fJUFI4. Accessed Nov. 9, 2011.
- Warnes CA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Journal of the American College of Cardiology. 2008;52:e143. Accessed Nov. 9, 2011.
- Clyburn RI, et al. Patent ductus arteriosus: Evidence for and against treatment. Journal of Pediatrics. 2007;150:216.
- Hammerman C, et al. Ductal closure with paracetamol: A surprising new approach to patent ductus arteriosus treatment. Pediatrics. In Press. Accessed Nov. 9, 2011.
- Preconception care questions and answers. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/preconception/QandA.htm. Accessed Nov. 14, 2011.