Patent Ductus Arteriosus Surgery

Patent Ductus Arteriosus (PDA) is a congenital heart defect found in the days or weeks after birth. The ductus arteriosus is a normal part of fetal blood circulation before a baby is born. It’s an extra blood vessel that connects 2 arteries: The pulmonary artery and the aorta. Before birth, the ductus arteriosus lets blood go around (bypass) the lungs. This is because the baby gets oxygen from the mother.

All babies are born with this opening between the aorta and the pulmonary artery. But it often closes on its own shortly after birth, once the baby breathes on its own. If it does not close, PDA occurs. Depending on your condition and the size of the PDA, your doctor will decide at what stage in your life to proceed with surgery.

Closure of the PDA can be done by cardiac catheterization or by surgery, almost always by cardiac catheterization. There is need for sedation or general anesthesia. There is no need for a heart-lung machine. The type of method chosen will vary according to your specific medical condition and on the size of the PDA.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

How to Prepare for the Procedure

Before the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Talk to your doctor about:

• All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
• Diabetes and how to adjust your medicine on the day of the procedure.
• Radiation exposure, especially for those that are pregnant.
• Any allergies to medicines, latex, tape, iodine, and anesthetic agents.
• Any history of bleeding disorders.
• Any implanted device (e.g. pacemaker or ICD).
• Any body piercings on your chest or abdomen.

Other recommendations include:

• Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
• Leave all jewelry at home.
• Remove all makeup and nail polish.
• Wear comfortable clothing when you come to the hospital.
• If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

Before the procedure, your doctor may perform a variety of diagnostic tests, including:

• Echocardiogram (ECHO)
• Cardiac catheterization
• Computed tomography (CT scan)
• Magnetic resonance imaging (MRI)
• X-Rays
• Electrocardiogram (EKG/ECG)

What to Expect During the Procedure

Depending on your medical condition as well as the size of the PDA, your doctor will choose the appropriate method for the procedure. For most PDAs, your doctor will likely use the cardiac catheterization method. This method usually takes 2 hours, but preparation and recovery may add several hours. The procedure is performed in the cardiac catheterization lab. Check with your doctor about the details of the procedure. In general, during a PDA closure (non-invasive procedure):

• You will change into a hospital gown.
• A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
• Prior to starting the procedure, you will receive a local anesthetic at the site of where the catheter will be inserted (typically groin). Your doctor will then make a small puncture at this site.
• Through this puncture, your doctor will insert the catheter. Within the catheter there’s a small device inside of it.
• Your doctor will guide this catheter to the PDA.
• Once the PDA is reached, your doctor will deploy the small device and therefore close the hole.
• Once the procedure is complete, the catheter will be removed and the incision will be closed with bandages.

What to Expect After the Procedure

After the procedure, you will be taken to the recovery unit for further observation for several hours. You may need to stay overnight. Other recommendations include:

General Guidelines

• Your vital signs, such as heart rate and breathing, will be watched.
• You may need to lie flat for several hours after the procedure without bending your legs.
• You may receive anticoagulants to keep blood from clotting.
• You may receive pain medicine if needed.
• Your doctor will give you instructions to follow during your recovery.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.