Indications for interventions are
- Failure to medical therapy
- Contraindicated to medical therapy (presence of kidney dysfunction, and decreased platelet count)
- Congestive Heart failure
- PDA diagnosed in an older infant.
- PDA that not are not spontaneously closed within 3 months of age; should be electively closed by the age of one to prevent complications.
Trans-Catheter device closure
This is a catheter-based procedure performed to close patent ductus arteriosus. This procedure is called “Trans-catheter device closure”. A thin tube called the catheter is inserted into the large femoral vein near the patient’s groin and pushed to the heart. At the end of the catheter, a coil (small rings of metal or a wiry mesh patch) is present. This metal coil is then placed in the ductus arteriosus to prevent the flow of blood through the vessel.
The patient is usually sedated during the procedure. This intervention if successful avoids the necessity of surgical open operation. Recovery is almost immediate. Patients may be discharged from the hospital in a day or two after catheter closure.
This procedure is highly effective and these patients generally do not need further treatment. Complications from this procedure are very rare. They may however include infection, bleeding and migration of the mesh or coil from its location.
References:Electronic Journal Article
- Indomethacin for asymptomatic patent ductus arteriosus in preterm infants. Cooke L, Steer P, Woodgate P - (http://www.cochrane.org/reviews/en/ab003745.html)
- Prophylactic intravenous Indomethacin for preventing mortality and morbidity in preterm infants. Fowlie PW, Davis PG - (http://www.cochrane.org/reviews/en/ab000174.html)
- Prolonged versus short course of Indomethacin for the treatment of patent ductus arteriosus in preterm infants. Herrera C, Holberton J, Davis P - (http://www.cochrane.org/reviews/en/ab003480.html)
- Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants. Shah SS, Ohlsson A - (http://www.cochrane.org/reviews/en/ab004213.html)
- Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants. Ohlsson A, Walia R, Shah S - (http://www.cochrane.org/reviews/en/ab003481.html)
- Oral Ibuprofen for Closure of Hemodynamically Significant PDA in Premature Neonates. Pramila Hariprasad, V. Sundarrajan, G. Srimathy, B. Suthagar, Ramadevi, B. Shyla. Indian Pediatrics 2002; 39: 99-100 - (http://www.indianpediatrics.net/jan2002/jan-99-100.htm)
- Khalil A et al. Incidence of congenital heart disease [PMID: 7875882] - (http://www.ncbi.nlm.nih.gov/sites/entrez? cmd=retrieve&db=PubMed&list_uids=7875882&dopt=medline)
Other Web References
- Patent Ductus Arteriosus (PDA) - (http://www.emedicine.com/emerg/topic358.htm)
- Congenital Heart Defects - (http://www.nhlbi.nih.gov/health/dci/Diseases/pda/pda_what.html)
- PATENT DUCTUS ARTERIOSUS (PDA) - (http://www.heartpoint.com/congpda.html)
- Patent ductus arteriosus - (http://www.nlm.nih.gov/medlineplus/ency/article/001560.htm)