Patent ductus arteriosus
PDA closure device
Actual size of a ductus arteriosus closure device, a few millimeters.
PDA closure
The device is attached to the catheter which is positioned in the ductus arteriosus. It is deployed to occlude it.
What is the patent ductus arteriosus?
Patent ductus arteriosus is a birth defect that occurs when the ductus arteriosus, a normal connection between the aorta and pulmonary artery in the fetus, does not close properly after birth. Normally, this duct allows blood to bypass the lungs and go directly to the baby's system. However, after birth, blood must be oxygenated by the lungs, and the ductus arteriosus closes quickly, usually within a few days to two weeks .
When the ductus arteriosus persists, some of the oxygenated blood, which should be redistributed to the rest of the body, returns to the lungs. This can lead to blood circulation problems and overload of the pulmonary system.
So why is closure of the patent ductus arteriosus proposed?
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Restore normal circulation: Closing the ductus arteriosus restores normal blood circulation. Oxygenated blood can then be distributed efficiently throughout the body, without overloading the lungs.
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Preventing complications: Patent ductus arteriosus can lead to complications, such as lung infections, heart problems, and pulmonary hypertension . Closing the ductus arteriosus early reduces these risks.
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Improve quality of life: Closing the ductus arteriosus improves the patient's quality of life by avoiding the symptoms associated with this malformation.
Depending on the medical assessment, catheterization of the right heart cavities may be proposed in advance to determine the indication for closure of the ductus arteriosus.
Performing the Closure of the patent ductus arteriosus:
The examination takes place in the interventional cardiology unit. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venous and arterial puncture in the groin and inserts a thin catheter. The catheter is guided to the heart. The device is deployed in the ductus arteriosus to block it. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check.
What are the complications of a patent ductus arteriosus closure procedure?
Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks:
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allergic complications most often linked to the use of anesthesia products.
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Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. Thrombosis of the artery can also occur.
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cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical.
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Cardiac complications after hospital discharge : Very rarely, displacement of the device or localized infection may occur.
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complications leading to death : they are very exceptional (<0.1%).
It is important to note that these complications are rare, and the benefits of ductus arteriosus closure usually outweigh the risks.
What benefits can be expected from patent ductus arteriosus closure?
Closure of the patent ductus arteriosus offers several benefits for the child:
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Normal height and weight growth.
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Improved exercise capacity: The child will have no limitations when playing and running.
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Reduced susceptibility to viral infections: The child will have fewer episodes of viral infections.
Closure of patent ductus arteriosus
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