Patent Ductus Arteriosus - Transcatheter closure factsheet

Introduction

Before birth, all babies have a normal blood vessel called the ductus arteriosus. This connects the pulmonary artery, which carries blood to the lungs. It also connects to the aorta, which carries blood to the body. It allows blood to bypass the lungs while the baby is growing in the womb. 

After birth, the ductus arteriosus usually closes on its own in the first few days of life. If it stays open, it is called a Patent Ductus Arteriosus (PDA). A PDA is more common in babies born early. 

 Signs and symptoms

When the ductus arteriosus stays open, some blood that should go to the body flows back to the lungs. This can make the heart and lungs work harder than normal. 

Children with a small PDA often have no signs. Larger PDAs can cause: 

  • fast breathing
  • getting tired when feeding
  • poor growth
  • frequent chest infections 

Diagnosis

A VSD is diagnosed by a doctor by: 

  • listening to the heart: they may hear a murmur
  • echocardiogram (heart ultrasound): this confirms the presence, size and location of the hole and how blood flows through it
  • electrocardiogram (ECG): this checks the heart rate and rhythm
  • chest X-ray: this shows the size of the heart and increased blood flow to the lungs 

Treatment

Transcatheter PDA closure is a minimally invasive procedure performed in the cardiac catheterisation laboratory (also known as the cath lab). It closes the hole using a special device, without the need for open-heart surgery. 

A transcatheter PDA closure involves: 

The procedure is done under general anaesthetic, so your child will be asleep and feel no pain.

A small tube (catheter) goes into a blood vessel in the leg (groin)

A small tube (catheter) is placed in a blood vessel in the leg (groin)

Using X-ray and ultrasound guidance, the doctor carefully moves the catheter up to the heart into the PDA

A tiny device (plug or coil) is placed inside the PDA to block the abnormal blood flow

The device stays in place permanently, and the heart lining grows over it with time

The catheters are removed, and a small dressing is put on the leg

The procedure takes about 1-2 hours and most children recover quickly

 Management

Risk and complications

Transcatheter PDA closure is very safe, but all medical procedures have some risks including: 

  • bruising or bleeding at the catheter site
  • the device moving before it settles- very rare
  • temporary irregular heart rhythm
  • narrowing of nearby blood vessels
  • infection or allergic reaction to dye or medicine 

Your child’s cardiologist will explain these and answer your questions before the procedure. 

Caring for your child after the procedure

In hospital:

  • your child will wake up in the recovery area and is closely monitored 
  • the leg used for the catheter must stay straight for a few hours
  • most children can eat and drink when awake
  • a chest X-ray or ultrasound may be done before going home 
  • most children go home later the same day or the next morning 

At home:

  • remove the dressing after 24 hours
  • back to school or daycare after 2 days
  • no rough play, cycling, or contact sports for a week
  • the cardiology team will arrange follow-up visits and scans