In most babies who have an otherwise normal heart, the ductus arteriosus will shrink and close on its own in the first few days of life. If it stays open longer, it may cause extra blood to flow to the lungs. When it doesn’t close as normal, the condition is known as a patent ductus arteriosus.

Problems can happen if the patent ductus arteriosus (PDA) is large. It causes a large amount of blood to flow to the lungs. When a smaller PDA is present, it is possible that it may close on its own by a child’s first birthday.

A PDA is more likely to stay open in a premature infant, particularly if the baby has lung disease. When this happens, doctors might need to close the PDA with medicines or surgically.

The specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine — the leading provider of pediatric heart care in Louisville and Southern Indiana — can help your child with a patent ductus arteriosus.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute have the skills and experience to provide a precise diagnosis and determine whether a PDA will close on its own, close with medications, or whether surgery is needed.

The Society of Thoracic Surgeons has rated Norton Children’s Heart Institute’s pediatric heart care among the best in the region. Norton Children’s has a network of outreach diagnostic and treatment services throughout Kentucky and Southern Indiana.

The Effects of a Patent Ductus Arteriosus

While a developing baby is in the womb, the baby gets oxygen directly from the mother’s placenta. The ductus arteriosus bypasses the lungs to send blood directly to the body. When a newborn breathes and begins to use the lungs, the ductus is no longer needed and usually closes by itself during the first two days after birth.

When it stays open, the PDA allows blood from the aorta to flow into the pulmonary artery. As a result, too much blood flows into the lungs, which puts a strain on the heart and increases blood pressure in the pulmonary arteries.

In infants born with other congenital heart conditions with decreased blood flow from the heart to the lungs or decreased flow of oxygen-rich blood to the body, the PDA may actually help, and the doctor might prescribe medicine to keep the ductus arteriosus open.

A persistent PDA is more common in premature babies and affects twice as many girls as boys. It is also common among babies with neonatal respiratory distress syndrome, babies with genetic disorders (such as Down syndrome) and babies whose mothers had rubella (also called German measles) during pregnancy.

Patent Ductus Arteriosus Symptoms

Babies with a large PDA might have symptoms such as:

• A strong and forceful pulse
• Fast breathing
• Not feeding well
• Poor growth
• Shortness of breath
• Sweating while feeding
• Tiring very easily

Diagnosing Patent Ductus Arteriosus

Your child’s doctor will listen for a heart murmur if a PDA is suspected.

Follow-up tests might include a chest X-ray, an electrocardiogram (EKG) to measures the heart’s electrical activity, an echocardiogram that uses sound waves to diagnose heart conditions and blood tests. Other tests performed may include:

• CT angiography: uses a computed tomography (CT) scanner to produce detailed images of the blood vessels following a dye injection.
• Chest X-ray: This shows pictures of the heart and lungs, and can show heart and lung issues, including extra blood flow or fluid in the lungs.
• Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show the structure of the heart and ductus arteriosus as well as the function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations throughout Kentucky and Southern Indiana.
• Electrocardiogram (ECG or EKG): A test that checks the heart’s electrical activity to show damage or irregular rhythms.
• Heart catheterization: This invasive procedure studies the structure, function, and provides direct pressure measurements of the heart and large blood vessels.

Patent Ductus Arteriosus Treatment

Three treatment options for PDA are:

• Medication
• Pediatric catheterization procedure to repair
• Surgery to repair

A doctor will close a PDA if the size of the opening is big enough that the lungs are becoming overloaded with blood, a condition that can lead to congestive heart failure and pulmonary hypertension.

A doctor also may close a PDA to reduce the risk of developing a heart infection called endocarditis, which affects the tissue lining the heart and blood vessels. Endocarditis is serious and requires treatment with intravenous (IV) antibiotics.

Why Choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is rated higher by the Society of Thoracic Surgeons than the Norton Children’s Heart Institute Pediatric Cardiothoracic Surgery Program.

• Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
• Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
• More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, for advanced heart care.
• Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
• The Society of Thoracic Surgeons rated Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to treat a range of pediatric heart conditions, including the most severe.
• Norton Children’s Heart Institute has satellite outpatient offices in Ashland, Bowling Green, Campbellsville, Elizabethtown, Frankfort, London, Madisonville, Murray, Owensboro, Paducah and Shepherdsville in Kentucky; as well as Corydon, Jasper, Madison and Scottsburg in Indiana; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
• The American Board of Thoracic Surgery has awarded the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
• The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.
• Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.