
Patent ductus arteriosus (PDA) is managed through medications, catheter-based interventions, and surgery. The primary aim is to close the PDA to prevent complications and reverse the effects of increased blood volume.
Small PDAs often close spontaneously, especially in full-term infants. However, treatment is necessary for infants with large PDAs or those experiencing health issues due to the condition.
Premature infants require treatment if the PDA is causing respiratory or cardiac problems.
Medications such as indomethacin or ibuprofen may be prescribed to facilitate PDA closure, particularly in premature infants. These drugs work by inducing constriction of the ductus arteriosus.
Catheter-based procedures, performed through cardiac catheterization, are commonly employed to close PDAs in infants or children. This minimally invasive approach involves inserting a catheter into a blood vessel, guiding it to the heart, and placing a blocking device in the PDA to halt blood flow. Complications are rare and typically short-term, including bleeding, infection, or displacement of the blocking device.
Surgery becomes necessary in cases where catheter-based procedures are not feasible or unsuccessful, particularly in very small infants or when there are associated congenital heart defects. The surgery, usually performed after six months of age, involves making a small incision between the ribs to access the PDA, which is then closed with stitches or clips. Complications from surgery are uncommon and may include hoarseness, diaphragm paralysis, infection, bleeding, or pleural effusion.