Patent ductus arteriosus
The patent ductus arteriosus is a connection between the aorta and the pulmonary artery.
PDA closure device
Actual size of a patent 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 there 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 your medical assessment, you may be offered a prior right heart catheterization to determine the indication for closure of the ductus arteriosus.
Procedure for closing the Arterial Duct:
Your examination will take place in the interventional cardiology unit.
Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks.
A small area of your groin will be shaved, which will be the access point for the examination.
A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table. It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device. Your body will be covered with a large sterile drape.
The procedure involves the implantation of a metal mesh device in the arterial duct. This flexible device is implanted by cardiac catheterization via a puncture of the femoral vein under local anesthesia.
In the absence of complications, the patient returns to their room and is monitored for 4 to 6 hours. Discharge is possible afterward.
What are the complications of a 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.
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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 deviceor 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.
PDA closure
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