Patent Ductus Arteriosus (PDA) in Babies
The short answer
Patent ductus arteriosus (PDA) occurs when the ductus arteriosus — a blood vessel that normally closes shortly after birth — remains open. It is very common in premature babies, occurring in about 60% of babies born before 28 weeks. In full-term babies, a PDA is less common but can occur. Small PDAs may close on their own. Larger PDAs can be closed with medication, catheter procedures, or surgery, with excellent outcomes.
By Age
What to expect by age
In premature babies, a PDA is often detected in the first days of life by echocardiogram, especially if the baby requires respiratory support. A characteristic "machinery-like" continuous heart murmur may be heard. Treatment options for premature babies include medications (indomethacin or ibuprofen) to promote closure, catheter-based closure, or surgical ligation. In full-term babies, a small PDA may be detected as an incidental murmur and often closes on its own within the first few months.
By this age, many small PDAs in full-term babies have closed spontaneously. If the PDA remains open but is small and causing no symptoms, watchful waiting continues. A moderate or large PDA that is causing symptoms — rapid breathing, difficulty feeding, poor weight gain, or bounding pulses — may need intervention. Catheter-based closure with an occluder device is now a preferred approach in many centers.
A persistent PDA that has not closed spontaneously is typically recommended for closure to prevent long-term complications such as pulmonary hypertension and heart failure. Even if the baby is asymptomatic, closure is generally recommended for moderate to large PDAs. The catheter-based closure procedure has a very high success rate and minimal recovery time.
After PDA closure — whether spontaneous, by catheter, or by surgery — children are expected to have a completely normal heart and no activity restrictions. Follow-up echocardiograms confirm successful closure. Very small PDAs that are hemodynamically insignificant may be monitored rather than closed, but most pediatric cardiologists recommend closure to eliminate the small risk of endocarditis.
What Should You Do?
When to take action
- Your baby's PDA was small and closed on its own within the first few months
- Your premature baby's PDA closed with medication (indomethacin or ibuprofen)
- Your baby had a successful PDA closure procedure and is growing and developing normally
- Your baby has a tiny PDA that the cardiologist considers hemodynamically insignificant
- Your baby has a heart murmur that was described as continuous or "machinery-like"
- Your baby with a known PDA is breathing fast, sweating with feeds, or not gaining weight
- Your premature baby's PDA did not close with medication and further treatment is being discussed
- Your baby is breathing very rapidly, appears in distress, or has a blue or gray color
- Your premature baby with a PDA develops worsening respiratory status requiring increased oxygen or ventilator support
Sources
Related Resources
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