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Patent Ductus Ateriosus
What
is Patent Ductus Arteriosus
(PDA)?
A Patent Ductus Arteriosus (PDA) is an
artery that is present in the fetus to connect the pulmonary artery to the
aorta. This vessel is necessary to divert blood flow away from the lungs
because the lungs are collapsed prior to birth. When the infant is born and
begins to breathe, there is a stimulus which causes the PDA to close. If the
PDA does not close, blood will flow from the aorta to the pulmonary artery
and out to the lungs, causing an excess of pulmonary blood flow. What
are the warning signs and symptoms of Patent Ductus
Arteriosus? If a PDA is
small, there are generally no symptoms. If the PDA is large, however, there
will be a significant excess in blood flow to the lungs, causing the heart to
have to pump more blood. This can lead to signs of congestive heart failure,
including labored breathing, difficulty feeding, and poor growth. How
is Patent Ductus Arteriosus
detected? The first
sign is often the presence of a heart murmur. The diagnosis is documented
with an echocardiogram. What
are the treatment options for Patent Ductus Arteriosus? For many
years, the only treatment option for Patent Ductus Arteriosus was surgical closure. More recently, it has
been possible to close certain types of PDA during a cardiac catheterization.
The catheter is threaded through the Ductus. Either
a metallic coil or an expandable metallic device is then passed through the catheter
and out the end of the catheter until it is positioned within the Ductus. This will then obstruct flow through the Ductus and the Ductus will no
longer be patent. Some Ductuses, however, are of a
certain size and shape that surgery is still necessary. Patent Ductus Arteriosus is quite
common in premature infants because the ductal
tissue is too immature to respond to the stimulus to close. It is often
possible to close these premature Ductuses by
giving a medicine called Indomethacin. This
medication is given intravenously and can stimulate the muscles of the Ductus Arteriosus to contract
and close. This medicine, however, is only successful in closing PDA in
prematurely born babies. |
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