Patent ductus arteriosus, or PDA, is a condition in which the ductus arteriosus does not close normally, according to MedlinePlus. The ductus arteriosus is a small blood vessel in the heart of an unborn baby that allows blood to bypass the lungs. After the baby is born, the lungs fill with oxygen and the duct closes. PDA results in abnormal blood flow between the heart and lungs. The condition is more common in premature infants and girls. The primary goal of treatment is to close the duct.
Wait-and-See Approach
MedlinePlus says premature infants have a high rate of PDA closure within the first two weeks, unlike full-term babies in which the PDA rarely closes on its own after the first weeks. During this time, physicians monitor the baby's heart to determine whether the duct is properly closing. If other heart conditions are present, doctors may choose to leave the PDA or even use medications to force it to remain open because it can act as a lifesaving device.
Medication
Nonsteroidal anti-inflammatory medications such as indomethacin and ibuprofen can be used, according to Drugs.com. Indomethacin may increase the risk of fatal heart complications such as heart attack or stroke. A study performed by the Newborn Services Department at George Washington University Hospital in Washington, D.C., found that the use of oral suspension ibuprofen was as effective as indomethacin and caused fewer adverse affects. The results of the study were published in the May 2007 issue of the American Journal of Perinatology. The medications work by blocking chemicals in the body that keep the duct from closing.
Surgery
If the duct doesn't close on its own or with medication, surgery may be required. Options include catheter procedures and open-heart surgery. Although catheter procedures are less invasive than open-heart surgery, MayoClinic.com explains that doctors rarely use those procedures as an immediate option in premature babies because their bodies are too small. If the PDA is not causing serious medical problems, physicians recommend holding off on catheter procedures until the baby is at least 6 months old. During the procedure, the surgeon threads a thin tube called a catheter up to the heart through a blood vessel in the groin area and inserts a coil into the duct to close the PDA. Risks include bleeding, infection and movement of the coil. During open-heart surgery, the surgeon makes a small incision between the ribs and closes the duct using a clip or stitches.
Preventative Care
If the PDA remains open, preventative measures may need to be taken throughout the child's life. Kids Health by Nemours explains that children with congenital heart defects are more prone to bacterial heart infections, called endocarditis. Prophylactic antibiotics may be given before surgeries and dental work. Because infected teeth and gums can contribute to the risk of endocarditis, it's important to schedule regular dental visits despite the potential risk.
