Treatment options for PDA?
Preterm babies (immature babies) PDA can be treated by giving medicines like paracetamol or brufen along with anti-failure medications. Majority of preterm PDAs can be closed by using these medications.
What are the other options for closing the PDA?
If preterm PDAs are not getting closed by medications, then other options are:
- Surgical ligation of PDA by left thoracotomy
- If size of PDA is 3.5-4 mm or less then can be tried to close in cardiac cath lab by using a button device (ADO II AS device, Picollo devices) angiographically (without open heart surgery).
What are the options for closing the mature babies (term babies) PDA?
- Term (matured babies) babies PDA if not getting closed by 48-72 hours of life, and if small in size, it can be followed up for next few months then it can be closed in cardiac cath lab by using a button/umbrella device angiographically (without surgery) around 9-12 months of age.
- If PDA is moderate to large in size then depending on symptoms of the child, it can be followed at regular intervals. Large PDA needs to be tackled early (in 3-6 months of age) and preferred option is by surgery as PDA is large in these cases.
- Moderate sized PDA patient can be followed and if not symptomatic then they should be treated around 6-12 months of age. In most of these cases, PDA can be managed by using a device in cath lab angiographically (without surgery).
How are PDAs closed in the cath lab?
PDA can be closed by using thigh blood vessels that are connected with the heart in a beating heart. For closing of PDA by using device, size of PDA as well as weight of child has to be taken in consideration.
This procedure is generally done under conscious sedation. Patient can be discharged on next day and can perform daily activities without any fear. Within six months, device become endothelized and become a part of heart for life long.
This method of closure of PDAs does not produce scar on the chest. There is no need of medicine intake after device closure of PDA.
Dr Gaurav Agrawal is a Pediatric Cardiologist (Child and Fetal heart Specialist). Dr Agrawal is a pediatrician who has specialized training in the treatment of various child heart related problems (neonates to 18 years of age). He is also having a vast experience in fetal echocardiography.
He is one of the very few pediatricians in India who practices pediatric cardiology exclusively. Cardiac problems in children are common in children, sometimes life threating and often not diagnosed properly. Early diagnosis and timely treatment is very important. Areas of specific interest include child echocardiography including fetal echocardiography, diagnostic and therapeutic cardiac catheterization (pediatric cardiac holes closure by device, opening of obstructed cardiac valves by balloons etc).