Key Points

• Patent ductus arteriosus (PDA) is a persistent connection between the aorta and the pulmonary artery after birth. This connection is called the ductus arteriosus, and it is normally present before birth. In most babies, the vessel closes within a few hours to days after birth. In some babies, the ductus arteriosus remains open (patent) after birth.
• PDA is more common in premature infants (babies born too early), but it can happen in full-term infants. It is twice as common in girls as in boys.
• The cause of PDA is not known. Genetics may play a role. PDA can occur in children with otherwise normal hearts or in children born with other heart defects.
• PDA allows too much blood to pump through the lungs, overloading the heart and the lungs. The heart must work harder than usual to pump the extra blood. This can cause the heart to enlarge and fluid to increase in the lungs.
• PDA can lead to poor growth, damage to the arteries in the lungs due to the extra blood flow, and bacterial endocarditis.
• A heart murmur may be the only sign that a baby or child has a PDA.
• Some infants may develop signs and symptoms of a large PDA such as fast breathing, poor feeding and poor weight gain, tiring easily, and sweating.
• Children with a large PDA are usually diagnosed within the first few months of life. Children with a small PDA may not be diagnosed until they are older. Premature infants with PDA may be diagnosed soon after birth.
• The echocardiogram is the test most commonly used to confirm the presence of a PDA.
• Small PDAs sometimes close without treatment. But if a PDA is large or does not close on its own by the time the child is 1–2 years old, it should be repaired. For premature infants, treatment is needed if the PDA is causing increased respiratory distress and heart problems.
• Treatments for PDA include medicine, procedures using catheters, and surgery.
• After closure of a PDA, most children grow normally and live healthy lives.