What is PDA?
A patent ductus arteriosus (PDA) is a blood vessel that normally closes within hours of birth but remains open. It connects the aorta to the pulmonary artery. During foetal life this vessel is essential; after birth it should close on its own — in PDA, it does not.
PDA accounts for 5–10% of all congenital heart defects and is especially common in premature infants.
"Parents often ask: 'The duct is small — can we wait and see if it closes?' My answer is always the same: no. A patent ductus arteriosus of any size is an indication for treatment. Waiting is not an option."
Symptoms in Children
Symptoms depend on the size of the duct:
- Small PDA — often asymptomatic; paediatrician hears a heart murmur
- Moderate PDA — easy fatigue, feeding difficulties, poor weight gain
- Large PDA — shortness of breath, frequent lung infections, developmental delay, signs of heart failure
Why is Treatment Needed at Any Size?
Even a small PDA places chronic strain on the pulmonary vessels. Over time this leads to irreversible changes — pulmonary hypertension. An open duct also raises the risk of infective endocarditis.
Important: After the neonatal period (beyond the first 3 months of life) the probability of spontaneous PDA closure is practically zero. Waiting only loses time and increases the risk of complications.
Treatment Methods
1. Catheter-based (endovascular) closure
A catheter is introduced through a vessel in the groin; a special coil or occluder closes the duct from inside. No chest opening, no surgical incision. The child stays in hospital 1–2 days. Today most PDAs are treated by this method.
2. Thoracoscopic clipping
Minimally invasive surgery — the duct is ligated through small port incisions. No large cut. Used when catheter closure is not suitable.
3. Open surgery
Through a small left-sided incision the duct is ligated. A reliable, time-tested approach used in complex anatomical situations.
The choice of method is individualised based on the child's age, weight, and duct size.
Treatment Outcomes
A timely closed PDA means complete recovery. The child develops normally and lives without restriction. The success rate of catheter closure exceeds 98%.
Can PDA be seen on echocardiography?
Yes. Colour-Doppler echo clearly shows the duct — its size, direction of blood flow, and the degree of pulmonary loading.
From what age can catheter closure be performed?
The catheter method is generally used in children older than 6 months and heavier than 6 kg. In younger or smaller children, thoracoscopic or open surgery is chosen. Each case is assessed individually.
How long does the child stay in hospital?
Catheter method: 1–2 days. Thoracoscopic: 3–4 days. Open surgery: 5–7 days. After discharge the child recovers quickly and returns to normal life.
Can a child with PDA play sport?
Intense physical activity is not recommended before treatment. After successful closure — full activity with no restrictions.