Patent ductus arteriosus

A patent ductus arteriosus ( ductus arteriosus persistens, patent ductus arteriosus, PDA ) occurs when the ductus arteriosus, (the main artery) and trunk connects between the aorta pulmonary artery ( pulmonary artery ) in fetal ( prenatal ) bloodstream three months has not been closed after the birth. It normally closes in the first days of life. The persistent ductus arteriosus is one of the congenital heart defects.

Symptoms

A small PDA does not cause any symptoms and falls within the scope of screening for only by a noise ( engine noise ). A larger PDA means a left-right shunt, again passes directly into the pulmonary circulation in the blood from the arterial circulation. This can lead to signs of heart failure and an increased susceptibility to infection of children. Since a larger PDA also poses a higher risk of endocarditis, a larger PDA is generally locked. In combination with various complex congenital heart defects, a patent ductus arteriosus, however, is artificially kept open to ensure the survival of children through the gift of prostaglandins.

Therapy

Medicinal

Is delayed, the natural closure, this can be supported by prostaglandinsynthesehemmender drugs, so in many cases a normal postnatal circulatory status is achieved. Approved for this indication is, for example, the active ingredient ibuprofen. In addition, indomethacin in the off- label use is employed.

In animals, the drug treatment is usually not possible because of the defect is not discovered until very late on the one hand and on the other hand, often present a different form of malformation in humans, the PDA that is not or no longer responds to the drug.

Invasive

Can not be achieved conventionally the closure, an invasive approach is necessary. Until 2005, this was done using a surgical procedure. The cut was made ​​at the left side of the chest between the ribs, the PDA cut off depending on the shape and length of one or two bands and often cut through between the constrictions.

Today, the PDA is closed at larger babies usually via a cardiac catheter containing one or more coils or a Schirmchensystem. For different brands are available, which are selected according to the shape and length of the PDA. A large PDA in very young infants is still closed surgically. After the closure of a PDA ( if it occurs as the sole abnormality ), the child is completely healthy. There is no need for endocarditis and more in the long run no more check-ups are to be expected.

In dogs and cats, it is possible to close the PDA in the same way by means of cardiac catheterization in some centers. Otherwise also, the closure during a chest surgery is possible.