Patent ductus arteriosus

Persistència del conducte arteriós a Vall d'Hebron

The ductus arteriosus is a blood vessel connecting the aorta to the pulmonary artery. It spontaneously closes after birth in the majority of infants born at full term, and this is essential in order for the baby to survive. However, in premature babies, closure of the ductus arteriosus is often delayed until more than a week after being born.

Description

Symptoms

The most common clinical sign is the onset of a murmur under the left collar bone. Patent ductus arteriosus may be accompanied by a high heart rate and rapid breathing and also increased pulmonary flow. This increase produces congestion which prevents development of the lungs in premature babies.

Who is affected by patent ductus arteriosus?

It principally affects premature babies. Patent ductus arteriosus affects 30% of premature babies weighing under 1500g.

Diagnosis

Patent ductus arteriosus is detected via echocardiogram.

Typical treatment

When the patent ductus arteriosus affects the new-born’s health, initial treatment is medical and pharmacological.

Pharmacological treatment

Indometacin is the standard treatment for closing the ductus arteriosus with medication. Ibuprofen can also be used as this anti-inflammatory gives good results in these cases.

Medical treatment

The usual treatment would be closure via catheterization. This means inserting a catheter into the ductus arteriosus to close it. This type of closure would normally be used for babies with ductus arteriosus under 3 mm diameter and who are of a suitable weight.

Surgical treatment is reserved for patients where pharmacological treatment has failed, or where it is not advisable, and for cases where catheterization is not recommended.

Prognosis is excellent both for closure through catheterization and surgery. The recanalization rate of patent ductus arteriosus is estimated at 0-3 %.