What Is Patent Ductus Arteriosus (PDA)?

Patent ductus arteriosus is the presence of a passage way (ductus arteriosus) between the pulmonary and aortic circulation which persists after birth.  This defect is caused by the failure of fetal ductus arteriosus to close.  

The defect allows flow of blood from the aorta (high pressure) back into the pulmonary circulation (low pressure).  It causes increased pulmonary blood flow.  This defect often closes naturally by 6 months of age.  The child may also have a VSD and / or coarctation of the aorta.  This defect is more often seen in females and accounts for 10 % of congenital heart defects.

Patent ductus arteriosus is typically present at birth; audible 'washing machine' murmur at the left sternal border, may also have widened pulse pressures and bounding pulses; increased volume to the lungs may result in volume over load.

It is diagnoses by physical findings; CXR may appear normal if defect is small or may reveal left sided cardiomegaly if defect is large.  Echocardiogram allows for direct visualization of defect.  ECG normal if defect is small, but indicates left ventricular hypertrophy if the defect is large.

Medication
Administer Indomethacin.
Treatment
Monitor cardiac and pulmonary status. Intake and output measurement is necessary.
Surgery
If asymptomatic, surgical repair is usually not utilized until the child becomes older (1 – 2 years).  If symptomatic (inability to wean from supplemental oxygen), PDA is ligated or banded.