Patent ductus arteriosus (PDA)

A patent ductus arteriosus is an unclosed hole within the aorta. Before a baby is born, the blood of the fetus does not have to travel to the lungs to induce oxygen but the blood vessel has a hole where the blood enables the blood to bypass circulation to the lungs and with the birth of the baby the blood must travel to the lungs to get The oxygen and this hole then closes, if the blood vessels remain open (or impassable), the blood may bypass this necessary step of the blood circulation, so the patent ductus arteriosus must be repaired and operazi offers an installment service for patients with heart and blood vessels.

What are the causes of patent ductus arteriosus?

● Normal ductus arteriosus in fetuses connects the aorta with the main lung artery (pulmonary artery), and allows blood to travel away from the lungs before birth.

● Every baby is born with a patent ductus arteriosus, but after birth, the opening is no longer needed and almost always narrows and closes within the few days after birth.

● Sometimes, the canal does not close after birth.

● Failure of the ductus arteriosus to close after birth is common in premature babies but is rare in full-term babies. In most babies, the explanation for PDA is not known, and some babies can develop other heart defects with PDA.

How does patent ductus arteriosus affect the heart?

● Normally the left side of the heart pumps blood only to the body through the aorta, so the right-side pumps blood only to the lungs.

● During a child with patent ductus arteriosus, more blood is pumped from the body's artery (aorta) into the pulmonary arteries.

● If the patent ductus arteriosus is open too much, a lot of blood is pumped into the lung arteries and this makes the heart and lungs work harder, and thus the lungs can become congested and suffocate.

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How does PDA affect my child?

Before learning how to repair a patent ductus arteriosus, know its effect on the child:

● If the patent ductus arteriosus is small in size, it will not cause symptoms because the heart and lungs have no difficulty, and it is detected by the abnormal sound which is a specific type of murmur (noise heard with a stethoscope).

● If the patent ductus arteriosus is too wide, the child may breathe faster and harder than usual, and children may have difficulty feeding and growing at a record rate.

● Symptoms may not appear until several weeks after birth and an air mass may develop within the blood vessels inside the lungs due to more blood being pumped there than usual.

● Over time, this can cause permanent damage to the blood vessels in the lung.

How is patent ductus arteriosus diagnosed?

Before you learn how to repair a patent ductus arteriosus, learn how to diagnose it. If a patent ductus arteriosus is suspected, the doctor uses a stethoscope to listen for a heart murmur, which is often heard in children with PDA repair. Follow-up tests may include:

● Chest X-ray.

● EKG, a test that measures the electrical activity of the heart and can show if the heart is enlarged.

● Ultrasound of the heart in children with patent ductus arteriosus, the waves show how large the opening is and how well the heart is dealing with it.

How to fix patent ductus arteriosus?

If the patent ductus arteriosus is small, it does not make the heart and lungs work as hard as possible, and surgery and other treatments may not be needed. PDA often repairs on its own within the first few months of life.

Most children can repair a patent ductus arteriosus (PDA) by inserting catheters (long, thin tubes) into the blood vessels within the leg to reach the heart. Also, a PDA can be repaired, by inserting an instrument through the catheter, a type of plug into the patent ductus arteriosus.

If surgery is required, an incision is made inside the left side of the chest, between the ribs. A patent ductus arteriosus is repaired by tying it with a thread or by permanently placing a low-profile metal clip around the ductus to press it to close.

If there is no other heart defect, this returns your baby's blood circulation to normal in a premature newborn.

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What activities can my child do?

If the patent ductus arteriosus is very small, or if it is closed with a catheter or surgery, your child may not need any special precautions regarding physical activity and should be able to participate in normal activities without increased risks.

For future follow-up, depending on the type of patent ductus arteriosus repair, a pediatric cardiologist may check it periodically to look for uncommon problems.

The long-term outlook is great, and you usually don't need medications and don't need additional surgery or catheters.

Preparing for the patent ductus arteriosus repair procedure

First: During the test

● This procedure is performed under local anesthesia (LA) in a cardiac catheterization lab.

● A plastic catheter (long tube) is inserted through a vein in the groin and moved to the heart.

● Depending on the condition, catheters may be placed in different chambers of your heart to measure pressure and oxygen content before the device is closed.

● In certain circumstances, a balloon may be needed in order to repair a patent ductus arteriosus (PDA).

● Once your doctor is satisfied with all measurements, the appropriately sized device is attached to a cable, and then placed into a tube toA special umbilicus, which is then inserted through the patent ductus arteriosus

● Your doctor will study the position and stability of the device before releasing it. The catheter will be removed and the procedure completed.

● The operation usually takes between one and two hours and a success rate of about 95%.

Second: the risks of patent ductus arteriosus repair

 There are known risks involved. The risks and their estimated incidence are:

● Organ dislocation and need for emergency cardiac surgery: <1%

● Death: <1% (usually from cardiac chamber perforation).

● Appearance of a clot or air bubbles to the brain (causing a stroke) and other organs: <1%

● Arrhythmia (usually transient): <1%

● The device distorts blood flow in the pulmonary artery: <1%

Other potential risks: Allergic reaction to the dye, anesthetic reaction, bleeding and bruising around the groin sheaths, injury to the artery/vein/nerves in the groin, infection, fever, headache, migraine, allergic reaction to the device's nickel component

Some of these complications, if they occur, are of a serious nature and may require further treatment, including surgery and prolonged hospitalization.