About Patent Ductus Arteriosus (PDA)

Patent ductus arteriosus (PDA) may be diagnosed in the days or weeks after your baby is born. The term patent means open, and in this case it refers to a connection between two arteries arising from your baby’s heart. The PDA is a normal part of fetal blood circulation that connects two arteries: the pulmonary artery, which takes blood to your lungs, and the aorta, which takes blood to your body. The PDA lets blood bypass (go around) the lungs while your baby develops in the womb. After birth, the connection naturally closes within a day or two once your baby starts breathing on his or her own. In preterm babies the PDA may not close, which can cause problems with breathing, feeding, and healthy growth.

Treating patent ductus arteriosus

Medicines are usually the first choice for closing a PDA, and they are often successful. Yet medicines sometimes fail, including in babies with larger openings or in very small infants. That’s when PDA closure devices are considered, especially if your preterm baby is having trouble breathing on his or her own, is not progressing, or is unable to be discharged from the hospital because he or she is not achieving health indicators required for going home.

About patent ductus arteriosus closure devices

Patent ductus arteriosus (PDA) closure devices are used to plug and stop blood flow through the PDA. Until recently, devices for closing a PDA were not designed for preterm or extremely low-birth-weight babies, and many infants required surgical closure. Current innovations have improved our options for achieving PDA closure, and we can now tailor our approach to each infant’s unique needs.

In 2019, the U.S. Food and Drug Administration (FDA) approved the revolutionary Amplatzer Piccolo™ Occluder. The device is designed specifically for low-birth-weight babies. It is the size of a pea and made of wire mesh. Fitting snugly in the opening, it effectively closes the PDA, promoting healthy heart and lung function. In FDA studies of the Piccolo device, 99 out of 100 patients had successful implants. Potential but uncommon risks include bleeding, infection, or movement of the device.

PDA device closure procedures offer clear benefits over surgery. They are minimally invasive procedures that are gentle to perform with good outcomes, few complications, and limited risks, even in infants as small as 700 grams (1.5 pounds).

PDA device placement

PDA device closure is performed in our advanced Cardiac Catheterization Lab. Our interventional cardiologists and pediatric cardiac anesthesiologists specialize in performing cardiac procedures in extremely small, high-risk babies.

During the procedure, a large IV is placed in a vein in your infant’s leg, and the device is guided from the vein to the heart using a catheter (long, narrow tube). Your interventional cardiologist uses fluoroscopy (x-ray video) and echocardiography (ultrasound) to see inside your child’s heart as she or he performs the procedure to ensure accurate placement. Once in place, the device rapidly closes the PDA and stops increased blood flow to the lungs.

The procedure generally takes less than 30 minutes to perform, and recovery occurs in a few hours. After the PDA is closed, babies are usually able to be weaned more quickly from artificial respiratory support.