Patent ductus arteriosus is a condition when a naturally forming blood vessel that helps a baby get oxygen from the placenta while in the uterus doesn’t close properly after birth. The ductus arteriosus is open while the baby is in the uterus to keep blood from entering the lungs.

The first cries from a newborn trigger the patent (open) ductus arteriosus to close, a process that takes a few days. In some babies, especially when born preterm, the patent ductus arteriosus can stay open too long and lead to a number of medical conditions.

A large and persistent opening causes a large amount of blood to flow to the lungs. A smaller patent ductus arteriosus may close on its own by a child’s first birthday.

Treatments to close a patent ductus arteriosus include medication, repair via catheter, traditional open surgery and an innovative minimally invasive procedure to implant a small plug in the opening.

The pea-sized plug, called the Amplatzer Piccolo Occluder, is an alternative to heart surgery to close the patent ductus arteriosus. It’s one of many innovative therapies used by the specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine. Once implanted, an interventional cardiologist expands the Piccolo, and eventually tissue grows over its mesh structure.

More Louisville and Southern Indiana families choose the board-certified and fellowship-trained specialists at Norton Children’s Heart Institute than any other pediatric heart care provider in the area. Treatment is available in Louisville or through a network of diagnostic and treatment services throughout Kentucky and Southern Indiana.

Patent Ductus Arteriosus Symptoms

Patent ductus arteriosus is more common in premature babies and affects twice as many girls as boys. It also is 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.

Symptoms of a large, persistent patent ductus arteriosus include:

• 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

The open blood vessel will be heard as a heart murmur by your child’s health care provider.

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

• CT angiography: A computed tomography (CT) scanner produces detailed images of the blood vessels following a dye injection.
• Heart catheterization: This invasive procedure studies the structure, function and direct pressure measurements of the heart and large blood vessels.

Patent Ductus Arteriosus Treatment

Four treatment options are:

• Medication
• Pediatric catheterization procedure to repair
• Surgery to repair
• Minimally invasive Piccolo implantation

A surgeon will close a patent ductus arteriosus if 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 surgeon also may close the opening 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.