The shunt that bypasses the lungs is called the foramen ovale. This shunt moves blood from the right atrium of the heart to the left atrium. The ductus arteriosus moves blood from the pulmonary artery to the aorta. Oxygen and nutrients from the mother’s blood are sent across the placenta to the fetus.

In the developing fetus, the ductus arteriosus, is a blood vessel connecting the pulmonary artery to the aortic arch. It allows most of the blood from the right ventricle to bypass the fetus’s fluid-filled non-functioning lungs.

The ductus arteriosus is a normal fetal artery connecting the main body artery (aorta) and the main lung artery (pulmonary artery). The ductus allows blood to detour away from the lungs before birth.

The ductus arteriosus carries blood away from the lungs and sends it 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 2 days after birth.

It is important to correct PDA because it can lead to congestive heart failure and a disease of the right side of the heart (called cor pulmonale) later in life. PDA also increases the risk of endocarditis, a life-threatening infection of the lining that covers the heart chambers, valves, and main arteries.

What are possible complications of PDA? If not treated, PDA may lead to long-term lung damage. It can also damage the blood vessels in the lungs. But this is not common because most children will have been treated for their PDA before the lungs and blood vessels get damaged.

There is no cure for PDA. Treatment interventions can be difficult for individuals with PDA as the nature of the disorder means that the individual is obsessively concerned with avoiding any demands placed upon them, including treatment methods.

Progression and Possible Complications If a moderate or large PDA is not treated, extra strain is placed on the heart and lung vessels. Irreversible damage to the blood vessels of the lungs can occur. If untreated, this damage can lead to death, typically in the fourth or fifth decade of life.

Patent ductus arteriosus is one of the most common congenital heart defects. About 3,000 newborns are diagnosed with PDA each year in the United States. Premature babies are more likely to have PDA, and the condition occurs twice as often in girls as in boys.

Symptoms

• Poor eating, which leads to poor growth.
• Sweating with crying or eating.
• Persistent fast breathing or breathlessness.
• Easy tiring.
• Rapid heart rate.

Echocardiogram. Sound waves produce images of the heart that can help the doctor identify a PDA , see if the heart chambers are enlarged, and judge how well the heart is pumping. This test also helps the doctor evaluate the heart valves and detect other potential heart defects.

Indomethacin is the most commonly used agent for medical closure of a ductus. Most studies have shown that the use of indomethacin in closing the PDA has reduced the need for subsequent surgical closure.

PDA is treated with medicines, catheter-based procedures, and surgery. The goal of treatment is to close the PDA to prevent complications and reverse the effects of increased blood volume. Small PDAs often close without treatment. Most children are healthy and live normal lives after treatment for a PDA.

Treatment may include: Medical management. In premature infants, an intravenous (IV) medication called indomethacin may help close a patent ductus arteriosus. Indomethacin is related to aspirin and ibuprofen and works by stimulating the muscles inside the PDA to constrict, thereby closing the connection.

Ibuprofen’s mechanism of action for closure of PDA is believed to be through the inhibition of prostaglandins. Clinical studies have shown ibuprofen to be as effective as indomethacin with fewer adverse effects. The ductus arteriosus is a blood vessel that connects the pulmonary artery to the aorta.

In children born full-term, early diagnosis and repair of PDA lets them live normal, healthy lives. Activity levels, appetite, and growth should return to normal. Your child’s cardiologist may advise that your child take antibiotics to prevent infection in the heart lining and valves (bacterial endocarditis).

Pregnant women are advised to avoid ibuprofen during pregnancy, especially if they’re 30 or more weeks pregnant. Taking the medication at 30 weeks and beyond could cause premature closing of a baby’s ductus arteriosus.

The success rate of NSAIDs for PDA closure is reported to be approximately 70-85%. While NSAIDs are known to inhibit COX activity via the arachidonic acid pathway, acetaminophen is thought to inhibit peroxidase activity in the same pathway, leading to downstream reduction of PGE-2.

Indomethacin is indicated for patent ductus arteriosus (PDA) closure, as it promotes closure of the PDA and generally has an onset of action within minutes. Prostaglandins, especially E-type prostaglandins, maintain the patency of the ductus.

Indomethacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache.
• dizziness.
• vomiting.
• diarrhea.
• constipation.
• irritation of the rectum.
• constant feeling of the need to empty the bowel.
• ringing in the ears.