Persistent Ductus Arteriosus (PDA)

The ductus arteriosus (DA) is a normalPersistent ductus arteriosus (PDA) vascular structure that typically connects the descending thoracic aorta to the pulmonary artery near the origin of the left pulmonary artery (LPA) and has an important physiological role in fetal life. Post birth, the DA is expected to close during the first week after birth. Persistence of the ductus arteriosus (PDAPersistent ductus arteriosus (PDA)) is common in preterm infants especially in those born below 26 weeks’ gestation but can occur also in term infants. Clinical manifestations of a PDAPersistent ductus arteriosus (PDA) are determined by the degree of shunting and the latter is largely determined by PDAPersistent ductus arteriosus (PDA) resistance and the ratio of systemic and pulmonary vascular resistance. A large left–right shunt can lead to pulmonary overcirculation, left atrial (LA) and left ventricular (LV) dilatation, and heart failureHeart failure. When not closed, large PDAsPersistent ductus arteriosus (PDA) can cause progressive pulmonary vascular diseasePulmonary vascular disease and obstructive pulmonary hypertensionPulmonary hypertension. A PDAPersistent ductus arteriosus (PDA) is also associated with an increased risk for endocarditisEndocarditis, albeit low. Clinical evaluation and echocardiography are used to assess the hemodynamic significance of a PDAPersistent ductus arteriosus (PDA). The presence of a hemodynamically significant PDAPersistent ductus arteriosus (PDA) (hsPDA) is an indication for intervention. The therapeutic options for PDAPersistent ductus arteriosus (PDA) include pharmacological treatment for premature infants, percutaneous closure by catheterizationDuct ligation, and surgicalTranscatheter ductal closure ligation.