Patent ductus arteriosus (PDA) is a heart condition in babies. This happens when the blood vessel called the ductus arteriosus doesn’t close as it should after birth. This opening is a normal part of a baby’s circulatory system in the womb that usually closes shortly after birth.
Before birth, a fetus’s blood won’t need to go to the lungs to get oxygenated. Ductus Arteriosus is a hole that allows blood to skip circulation to the lungs. But, after the baby is born, the blood must receive oxygen in the lungs and this hole is supposed to close. In case the hole is left open, it’s called patent ductus arteriosus, or PDA. If the PDA is small, it may cause no problems and need no treatment, but if a large PDA is left untreated it can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications soon after birth.
Patent Ductus Arteriosus (PDA) is a congenital heart defect that leaves an opening between two major blood vessels leading from the heart. This condition occurs when the ductus arteriosus, a blood vessel that’s a normal part of a baby’s circulatory system before birth, fails to close after birth.
In the womb, the ductus arteriosus allows blood to bypass the lungs, which aren’t yet needed for oxygenation. However, after birth, the baby’s blood needs to receive oxygen in the lungs, and this hole is supposed to close. If it remains open, it’s referred to as patent ductus arteriosus.
The size of the opening can vary, leading to symptoms that range from mild to severe. If the opening is very small, there may be no symptoms. However, a larger opening can lead to symptoms such as a heart murmur, rapid heartbeat, breathlessness, fast breathing, poor feeding, slow growth, low weight, and cardiomegaly (an enlarged heart).
The exact cause of PDA is not known, but it’s more common in premature infants and rare in full-term babies. Risk factors include preterm birth, family history, genetic conditions such as Wiedemann-Steiner syndrome, Loeys-Dietz syndrome, rubella infection, and chromosomal abnormalities.
If left untreated, PDA can lead to complications such as pulmonary hypertension, heart failure, and endocarditis. Diagnosis typically involves non-invasive tests such as auscultation, echocardiogram, electrocardiogram (ECG or EKG), and chest X-ray.
The symptoms of patent ductus arteriosus differ whether the baby is premature or full-term. A patent ductus arteriosus may at first appear as a heart defect, as the doctor will hear a heart murmur while listening to your baby's heart through a stethoscope. Babies with a large PDA might have symptoms such as:
A bounding (strong and forceful) pulse
Fast breathing
Not feeding well
Shortness of breath
Sweating while feeding
Tiring very easily
Poor growth
Treatment options for a patent ductus arteriosus include monitoring, medications, and closure by cardiac catheterization or surgery.
As the surgeon makes a small cut between the patient's ribs, they reach the heart and repair the open duct using stitches or clips. Therefore the child will remain in hospital for several days for observation. Patients usually fully recover in a few weeks from surgery.
Patent Ductus Arteriosus (PDA) is a heart condition that can be managed with various treatment options depending on the size of the opening and the severity of the symptoms. If the PDA is small and not causing health problems, it may not require treatment but will need monitoring. In many cases, small PDAs can close on their own within the first few months of life.
Medication is one of the treatment options for PDA. Nonsteroidal anti-inflammatory drugs (NSAIDs) like Indomethacin can help close the duct. This drug is effective only among premature babies.
In cases where the opening is large, more invasive procedures may be required. One such procedure is a catheter-assisted procedure. In this procedure, a device is inserted through a catheter into the opening of the femoral artery. This device blocks the flow of blood through the opening, restoring normal blood flow.
Cardiac surgery is another treatment option for PDA. This is usually done for children above 6 months of age. During the surgery, the doctor will close the duct to correct the defect.
It’s important to note that all these treatments should be performed by a specialist, such as a cardiologist, who specializes in the diagnosis and management of heart-related disorders.
The exact cause of PDA is not known, but several factors are believed to contribute to its occurrence. Risk Factors for PDA include:
Preterm Birth: PDA occurs more commonly in babies who are born prematurely than in babies who are born full term. The risk increases the earlier the baby is born. For instance, PDA occurs in about 10% of babies born between 30 and 37 weeks of pregnancy, 80% of babies born between 25 and 28 weeks of pregnancy, and 90% of babies born earlier than 24 weeks of pregnancy.
Family History and Genetic Conditions: A family history of heart problems present at birth may increase the risk for a PDA. Certain genetic conditions such as Wiedemann-Steiner syndrome and Loeys-Dietz syndrome also increase the risk.
Rubella Infection: Infections during pregnancy, especially rubella virus, can increase the risk of PDA.
Chromosomal Abnormalities: Certain chromosomal abnormalities may also increase the risk of PDA.
If left untreated, PDA can lead to several complications. Complications of PDA include:
Pulmonary Hypertension: A large PDA causes irregular blood flow in the heart and lungs. As a result, pressure rises in the lungs, leading to pulmonary hypertension.
Heart Failure: Over time, the increased workload on the heart can cause it to enlarge and weaken, leading to heart failure. This is a serious condition where the heart can’t pump enough blood to meet the body’s needs.
Endocarditis: This is an infection of the inner lining of the heart chambers and valves. People with PDA are at a higher risk of developing endocarditis.
Respiratory Problems: Babies with moderate or large PDA can experience problems with breathing as their bodies try to keep up with the extra blood in their lung arteries.
Growth Problems: Babies with PDA may have trouble feeding and gaining weight.
Untreated PDA can lead to serious complications, including pulmonary hypertension, heart failure, endocarditis, respiratory problems, and growth problems. Therefore, early diagnosis and treatment are crucial to prevent these complications and ensure the health of the baby.
Equipped hospitals and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Iran it’s an appropriate choice for parents with babies suffering from patent ductus arteriosus. Tehran has some of the best hospitals for treating PDA.
In Iran, the cost of PDA treatment can vary widely depending on several factors, including the specific procedure used, the healthcare provider, and the patient’s individual needs. Iran is known for its high-quality medical services and affordable prices, making it a popular destination for many people seeking medical treatments. The cost of PDA treatment in Iran ranges from around 4000-6000 USD.
The main methods for treating PDA include pharmacological treatment, surgical closure, and interventional closure. Pharmacological treatment involves the use of medications such as Indomethacin, Ibuprofen, and Acetaminophen. Surgical closure and interventional closure are more invasive procedures and are typically used for larger openings. The costs for these procedures can be higher due to the complexity of the procedures and the specialized equipment required.
The cost of PDA treatment in Iran can vary widely depending on several factors. However, with its combination of skilled doctors, advanced technology, and affordable prices, Iran has become a popular destination for this medical procedure. It’s important to note that these are average costs and the actual cost can vary based on individual needs and the specific clinic chosen. Therefore, it’s recommended to have a consultation with a healthcare provider to discuss your specific needs and to get a more accurate estimate of the cost.
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PDA is a heart defect found in the days or weeks after birth. This occurs when a normal fetal connection between the aorta and the pulmonary artery does not close as it should after birth. Usually PDA happens in premature infants.
In order to reach the child’s heart and repair the open duct, the surgeon will make a small cut between the ribs. Afterwards, your child will remain in the hospital for several days for observation. It usually takes a few weeks for a child to fully recover from heart surgery.
A large PDA is dangerous. PDA which is most common in premature infants, will cause uncontrolled blood flow to the lungs, leading to problems with the lungs and heart.
In most infants, the ductus arteriosus remains open for a short period after birth, and is eventually closed by 8 weeks of age. If the vessel remains open after birth it is called a patent ductus arteriosus.
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