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Patent Ductus Arteriosus (PDA)

What is Patent Ductus Arteriosus?

Patent Ductus Arteriosus is a Congenital Heart Disease characterized by persistence of a connection between the aorta and the pulmonary artery. Ductus Arteriosus is a blood vessel joining the pulmonary artery (main artery to the lungs) to the aorta (main artery to the body) during fetal life. Patent Ductus Arteriosus allows the blood from the aorta to flow into the pulmonary artery instead of going to rest of the body. As a result there is increased workload on the left side of heart and the lungs.

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Where can I get a Patent Ductus Arteriosus?

Country Cost with MedSolution
India $1,875  (inquire)
Cost of procedure performed in the US: $58,000.
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

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What are the effects of Patent Ductus Arteriosus?

  • Breathlessness - Since there is extra blood flowing to the lungs from the left ventricle, this weakens both the lungs and the heart. The left side of heart enlarges and there is accumulation or congestion of fluid in the lungs giving rise to a condition called Congestive Heart Failure. This is a very serious condition that arises as a complication of untreated Patent Ductus Arteriosus.
  • Pulmonary Vascular Disease - The pulmonary arteries may become stiff and thickened and offer increased resistance to the flow of blood (pulmonary hypertension).
  • Bacterial Endocarditis - Due to persistent irritation of the point of connection between the aorta and the pulmonary artery, it easier for bacteria in the bloodstream to collect and grow there. People with Patent Ductus Arteriosus are especially prone to bacterial endocarditis.

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How is Patent Ductus Arteriosus diagnosed?

Like all other Congenital Heart Disease (Atrial Septal Defect, Ventricular Septal Defect) Patent Ductus Arteriosus can be diagnosed by:

  • Physical Examination - There will be difficult or rapid breathing, poor feeding, tiring easily, poor growth and development and a heart murmur. Heart murmur is the extra sound produced by the heart due to turbulent blood flow.
  • Echocardiogram - This procedure utilizes sound waves to generate an image of the heart.
  • Electrocardiogram - This procedure also known as ECG or EKG measures the rate and regularity of the child's heartbeat.
  • Chest X-ray - This can show if the heart is enlarged or if there is accumulation of fluid in the lungs.

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What does the surgical treatment of Patent Ductus Arteriosus involve?

Like other Congenital Heart Diseases, Patent Ductus Arteriosus can close spontaneously if it is small. However, surgical intervention may be needed if the Patent Ductus Arteriosus does not close until your child is 6 months of age. The surgical repair for Patent Ductus Arteriosus is performed under general anesthesia in a hospital setting. Your Pediatric Cardiac surgeon will make a small incision between the ribs on the left side and the ductus arteriosus is tied and cut.

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What is the recovery period like after the surgical treatment of Patent Ductus Arteriosus?

Immediately following the surgery for Patent Ductus Arteriosus, your child will spend a few hours in the ICU under observation for immediate post-operative complications. Your child will spend about 2 days in the hospital until the surgical staff is satisfied with the outcome of the surgical repair of Patent Ductus Arteriosus. The recovery is generally complete in about 3 months. Your child will be prescribed anti-coagulant medication to reduce the risk of clot formation. Follow the nurses instructions carefully on how to care for your child e.g. bathing, activity level, direct injuries to the chest while playing and medications to be given at home.

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What is the outcome of surgery for Patent Ductus Arteriosus?

In majority of cases, there are not complications with successful results following surgical closure of Patent Ductus Arteriosus as children have a remarkable ability to heal and recover quickly. There is usually no residual leakage. After the surgery for Patent Ductus Arteriosus, there might be some pain and discomfort which soon subsides. Your child will be able to participate in all the normal activities pretty soon leaving all the memories of pain an discomfort behind.

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B . R . A . N . D . of surgery for Patent Ductus Arteriosus

Benefits of surgery for Patent Ductus Arteriosus

  • The surgical repair of Patent Ductus Arteriosus gives your child the life that he / she deserves! Following the surgery, you will observe a significant level of difference in your child's growth and development, activity level, appetite and general well being. Your child will be able to participate in and enjoy all the activities without any restrictions. There are unmistakably good long-term results for children who undergo surgical repair of Patent Ductus Arteriosus or surgical repair for other Congenital Heart Diseases.

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Risks of surgery for Patent Ductus Arteriosus

  • Bleeding
  • Infection
  • Allergic reaction to anesthesia
  • Stroke
  • Heart attack
  • Bacterial endocarditis - Bacterial infection of the heart valve.

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Alternatives to surgery for Patent Ductus Arteriosus

  • Medications - Diuretics, Digoxin and antibiotics may be used as palliative measures to stabilize people with Patent Ductus Arteriosus. Indomethacin is a viable option to be used in pre-mature infants to close the Patent Ductus Arteriosus. Indomethacin works by constricting the muscles in the wall of Ductus Arteriosus.
  • Cardiac Catheterization Procedures (Trans-cath Closure) - Catheter procedures are often used to close Patent Ductus Arteriosus in infants or children who are old enough to have the procedure. Your child's doctor may refer to the procedure as 'transcatheter device closure'. The procedure is sometimes done on a small Patent Ductus Arteriosus to prevent the risk of bacterial endocarditis.

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Now or Never

  • Surgical closure of Patent Ductus Arteriosus has very few chances of complications. Once the defect has closed spontaneously or has been repaired surgically, most children do not need additional treatment or medications and can live normal, healthy lives.

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Decision to have surgery for Patent Ductus Arteriosus

  • Patent Ductus Arteriosus can have several damaging effects over time, including enlargement of the left atrium and ventricle, damage to the arteries and blood vessels in the lungs, congestive heart failure, and irregular heartbeats or rhythms (arrhythmias). Patent Ductus Arteriosus that does not close on it's own can often be closed through surgery or Cardiac Catheterization procedure. With the advent of sophisticated surgical techniques and equipment, closure of Patent Ductus Arteriosus is usually successful with excellent long-term results.

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Keywords: Congenital Heart Disease, Congestive Heart Failure, Arrhythmia, Stroke, Heart Attack, Bacterial Endocarditis

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