Patent ductus arteriosus

Abstract

Patent ductus arteriosus accounts for 5-10 % of all congenital heart diseases with an incidence of 1 in 2,000 live births in children born at term. The failure of ductus arteriosus closure results in a left-to-right shunt that can lead to pulmonary vascular and left ventricular volume overload. Necrotizing enterocolitis, myocardial dysfunction, systemic hypotension, altered intracerebral blood flow, and intracerebral and intraventricular hemorrhage have been associated with failed ductal constriction. Transthoracic echocardiography remains the gold standard method for patent ductus arteriosus diagnosing. Therapy options designed to close a patent ductus arteriosus in premature infants remain challenging. Previously, medical therapy with indomethacin or surgical ligation constituted the only two options for symptomatic patent ductus arteriosus. Nowadays, the use of paracetamol and the advent of smaller occlusion devices and transcatheter therapy have gained importance as alternative treatments of hemodynamically significant patent ductus arteriosus, with reports of even treating patients <1 kg.