Treatments for patent ductus arteriosus depend on the age of the person being treated. Options might include:
- Watchful waiting. In a premature baby, a PDA often closes on its own. The doctor will monitor your baby's heart to make sure the open blood vessel is closing properly. For full-term babies, children and adults who have small PDAs that aren't causing other health problems, monitoring might be all that's needed.
- Medications. In a premature baby, nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Infant's Motrin, others) or indomethacin (Indocin) — might be used to help close a PDA. NSAIDs block the hormonelike chemicals in the body that keep the PDA open. NSAIDs won't close a PDA in full-term babies, children or adults.
- Surgical closure. If medications aren't effective and your child's condition is severe or causing complications, surgery might be recommended. A surgeon makes a small cut between your child's ribs to reach your child's heart and repair the open duct using stitches or clips.
After the surgery, your child will remain in the hospital for several days for observation. It usually takes a few weeks for a child to fully recover from heart surgery. Occasionally, surgical closure might also be recommended for adults who have a PDA that's causing health problems. Possible risks of the surgery include hoarseness, bleeding, infection and a paralyzed diaphragm.
- Catheter procedures. Premature babies are too small for catheter procedures. However, if your baby doesn't have PDA-related health problems, the doctor might recommend waiting until the baby is older to do a catheter procedure to correct the PDA. Catheter procedures can also be used to treat full-term babies, children and adults.
In a catheter procedure, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil is inserted to close the ductus arteriosus.
If the procedure is done on an outpatient basis, you or your child probably won't stay overnight in the hospital. Complications from catheter procedures include bleeding, infection, or movement of the plug or coil from where it was placed in the heart.
In the past, people who've had a PDA were advised to take antibiotics before dental work and certain surgical procedures, to prevent a heart infection (infective endocarditis). Today, preventive antibiotics are no longer recommended for most people with a patent ductus arteriosus.
You or your child may need to take preventive antibiotics the first six months after a catheter repair procedure, if there's still damage after the repair, or if you had infection in the heart previously. Talk to your doctor about whether you or your child needs to take antibiotics before any procedures.
Needed follow-up care
If you have PDA, even if you had surgery as a child, you may be at risk of developing complications as an adult. Therefore, it's important to have lifelong follow-up care, especially if you had corrective heart surgery.
This follow-up care could be as simple as having periodic checkups with your doctor, or it may involve regular screenings for complications. The important thing is to discuss your care plan with your doctor and make sure you follow all of your doctor's recommendations.
Ideally, a cardiologist trained in treating adults with congenital heart defects will manage your care.