Heart and Blood Conditions
Patent Ductus Arteriosus
What is patent ductus arteriosus?
Patent ductus arteriosus (pronounced PAY-tent DUCK-tus are-teer-e-OH-sus) occurs when a small blood vessel near the heart fails to close after a baby is born. (See a picture.) This is also called persistent ductus arteriosus.
The ductus arteriosus is a temporary blood vessel that babies have before they are born. The ductus arteriosus connects the pulmonary artery to the aorta. It allows blood to bypass the lungs when the fetus is growing in the womb.
During the fetus’s development in the womb, the majority of blood flow leaves the heart through the ductus arteriosus. This allows the lungs to receive only a small amount of blood flow while the fetus is in the mother’s womb. This works fine because babies don’t breathe on their own until after they’re born. Fetuses don’t need large quantities of blood going to their lungs to get oxygen. Before birth, the fetus gets oxygen through the placenta.
Normally, when a newborn baby takes its first breath, they have been separated from the mother’s blood supply and all the chemicals keeping the ductus arteriosus open (patent) have now been taken away. The ductus typically closes within a few days.
If the ductus arteriosus remains open, pressure from the blood vessels will provide extra blood flow to the baby’s lungs. This additional blood flow then returns to the heart and can cause the heart’s left side to get too large. If not treated, this could lead to heart failure.
A ductus that doesn’t close is common in premature babies but rare in full-term babies.
Patent ductus arteriosus is diagnosed in about 3,000 babies each year in the United States. Girls are 2 to 3 times as likely as boys to have it.
Some babies with patent ductus arteriosus have other heart defects, but not all do.
This condition is more common in babies with Down syndrome and in babies whose mother had German measles (rubella) while pregnant.
Doctors may give medicine (prostaglandin) to babies who have a normal ductus that’s closing but have other kinds of heart defects (like hypoplastic left heart syndrome, interrupted aortic arch or pulmonary atresia) to keep the ductus open. Keeping the ductus open helps blood flow through the baby’s heart and into the body until their other heart defects can be treated.
Patent Ductus Arteriosus at Seattle Children’s
U.S. News and World Report consistently ranks Seattle Children’s cardiology and heart surgery program as one of the best in the country. With more than 40 pediatric cardiologists, we have experience diagnosing and treating every kind of heart problem.
Our heart team has treated many children with patent ductus arteriosus. We have years of experience with the treatment these patients may need, including medicine, cardiac catheterization or surgery. We have a team of doctors that includes pediatric cardiac anesthesiologists, newborn (neonatal) intensive care physicians, cardiac intensivists, cardiac interventionists and cardiac surgeons.
Seattle Children’s has been treating children since 1907. Our team members are specially trained in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
The Adult Congenital Heart Disease Program shared by Seattle Children’s and the University of Washington can help with care throughout your child’s life.
When an infant, child or young adult arrives at Seattle Children’s, a team of people will take care of them. Along with your child’s heart doctor (cardiologist), you are connected with newborn baby intensive care physicians (neonatologists), lung doctors (pulmonologists), nurses, child life specialists, social workers and others, if their expertise is needed.
We’re committed to your child’s overall health and well-being. We’ll discuss treatments in ways you can understand and involve you in every decision.
Symptoms of Patent Ductus Arteriosus
Babies whose ductus arteriosus does not close may not have any symptoms unless their ductus is large and their heart and lungs are getting too much blood as a result.
If the baby does have symptoms, they may include:
- Fast breathing and fast heartbeat
- Working hard to breathe
- Trouble feeding
- Difficulty gaining weight (failure to thrive)
- Getting more tired than normal
Diagnosing Patent Ductus Arteriosus
To diagnose this condition, your doctor will examine your child and use a stethoscope to listen for a heart murmur. Sometimes, doctors find patent ductus arteriosus after hearing a heart murmur in a child who appears well. They may not hear a murmur and not find the ductus problem until the child is older.
If your doctor suspects patent ductus arteriosus, your child will need an echocardiogram test so the doctor can see how their heart works. To get more information, your child may need other tests, like chest X-rays or an electrocardiogram.
Treating Patent Ductus Arteriosus
Patent ductus arteriosus may close on its own over time. Premature babies are more likely to have patent ductus arteriosus close on its own. If your baby’s ductus is small and not causing problems, your doctor may suggest waiting to see if it closes in your child’s first year or two.
If the ductus is large, it is likely to cause problems or has already caused problems with your baby’s blood flow, breathing or heart function. Your doctor may suggest taking steps to close it.
Treatment Options for Patent Ductus Arteriosus
In premature babies, medicines may make the ductus tighten and close. Doctors use indomethacin or ibuprofen to do this.
In full-term babies, the ductus arteriosus can usually be closed with a cardiac catheterization procedure. The doctor uses a small, thin tube (catheter), inserted through a blood vessel in the leg, to close the ductus arteriosus. This procedure is done while your child is sedated (general anesthesia).
Some premature infants and children who have a ductus arteriosus that is too large to close with cardiac catheterization may need surgery.
Contact the Heart Center at 206-987-2015 for a cardiac referral, a second opinion or more information.