Patent Ductus Arteriosus (PDA) is a common congenital heart disorder. Every infant is born with a ductusarteriosus. After birth, the opening is no more needed and it normally narrows and closes over the first couple of days of existence. Failure to do this leads to Patent DuctusArteriosus (PDA) allowing blood to flow from the aorta into the pulmonary artery.
If the PDA is large, the heart will be volume loaded resulting in heart failure. The PDA also carries a risk of bacterial infection (Endocarditis) and pulmonary hypertension.
Cause of Patent Ductus Arteriosis (PDA)
The precise source of patent ductusarteriosus is not understood, can be a hereditary defect. PDA is commonly seen in:
- Premature infants
- Babies That have genetic conditions like Down syndrome
- Babies whose mothers had rubella during pregnancy
- PDA is twice as common in women as it is in boys
Indication for PDA closure
- The Existence of volume overloading of the left atrium and left ventricle
- Risk of endocarditis
- Risk of Pulmonary hypertension
- Aneurysm of PDA
Signs and Symptoms
Depends on the size of the PDA:
- If PDA is small, a certain Heart murmur also referred to as a machine murmur could be the only indication of patent ductusarteriosus (PDA).
- If Large PDA, apart from the murmur, some can develop signs or symptoms
- Breathlessness
- Poor feeding and poor weight gain
- Easily tired
- Easy Sweating like with feeding
Diagnostic Tests
- Echocardiography (echo) is the most important test available to both diagnose a heart problem and follow the problem over time.
- CXR
- ECG
- Doppler study
Treatment of PDA Device Closure
- Routine monitoring and Medicines,
- Surgery
- Transcatheter closure of PDA utilizing the occluder device was proven to be safe and efficacious.
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Procedure
Before Procedure
- Medical history noted and clinical Evaluation of the child Conducted
- Advised general Evaluations to Test for fitness of Operation
- Counseled Concerning the Process
During Procedure
- The procedure generally takes approximately 1 to 3 hours.
- Normally performed in the cardiac catheterization laboratory.
- Access from the femoral vein is got with the positioning of a sheath. A sheath is placed in the femoral artery.
- The unit is then advanced to the point of the sheath from the descending aorta The sheath and apparatus are then pulled into a position.
- When a great position is accomplished, the sheath is retracted farther along with the tubular region of the unit is opened inside the PDA.
- An angiogram is done from the descending aorta to validate the final apparatus position up for this measure, the apparatus could be repositioned or recovered if the angiogram showed significant residual stream.
- Sometimes a repeat angiogram is done at the descending aorta ten minutes afterward.
- If the apparatus position is satisfactory, the device is released.
After Procedure
- The patient is hospitalized for a day to track the vitals.
- An X-ray and echo doppler study performed another day following the procedure to be certain that the closure device has not moved.
- Normally discharged after evaluation and kept on an antibiotic.
- Subacute bacterial endocarditis prophylaxis is suggested for six months or until complete closure is acquired.
- The cardiologist may advise some physical activity restrictions for a short time.
- Pregnancy is reduced risk in patients using PDAunless there is pulmonary hypertension or signs of heart failure.
- Follow-up the patient incorporates clinical examination, transthoracic echocardiography, and CXR performed at regular intervals.
Complications
Though rare, may include:
- Bleeding
- Infection, and
- Displacement of the blocking device from where it was placed
- Transient arrhythmia
- Allergic reaction to the device
- Clot formation
Prognosis of PDA Device Closure
PDA closure procedure has a roughly 95% success rate. The long-term prognosis is great and generally, no medications and no extra surgery or catheterization are required.
Factors Affecting the Cost of PDA Device Closure
Following are the factors that will affect the therapy price:
- The hospital patient is opting for
- Operating room, recovery room fees
- The fee to the group of physicians (Cardiologists, Anesthesistetc)
- Medicines and sterile dressings
- Regular evaluation and diagnostic processes
- Price of Apparatus
- Price of follow up care
Read More – VSD Closure Surgery Cost in India
The Most Important Frequently Asked Questions
Q: What Is Ductus Arteriosis?
A: The ductus arteriosus is a hole that allows the fetal bloodstream vessels to bypass the flow to the lungs.
Q: When Is PDA First Suspected in Infants?
A: In infants, patent ductus arteriosus (PDA) is first suspected when the doctor during a regular checkup hears a heart murmur.
Q: Why Is the Size of PDA Important in Planning Treatment?
A: Small PDAs often close on their own within the first few months of life. If a PDA is large, the infant also may develop symptoms of volume overload and increased blood flow to the lungs, then closure would be necessary.
Q: Who Will Treat Children With PDA?
A: A pediatric cardiologist is qualified in treating the condition in children.
Q: Can PDA Close on Its Own?
A: A small PDA may close on its own as the child grows, the cardiologist will check periodically whether the PDA is closing on its own. A large PDA or that causes symptoms will need to be treated.
Q: What is PDA Device Closure?
A: In PDA Device closure a catheter is put through a blood vessel to the heart following which the closure device is threaded through the catheter and placed into the PDA. This device blocks blood flow through the vessel thereby closing it.
Q: How Long Does the Procedure Take?
A: Depending on the complexity of the procedure, it normally takes 1-3 hours.
Q: Can I Get a Visa on Arrival If I Travel to India for My Treatment?
A: Yes, if you are from the following countries, Japan, Cambodia, Finland, Indonesia, Philippines, Luxembourg, Myanmar, New Zealand, Singapore, South Korea, and Vietnam. Travelers from Bhutan, Nepal, and Maldives (up to 90 days) can enter India without a visa.
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