Patent Ductus Arteriosus
The ductus arteriosus is a large artery connecting the lung artery with the aorta. It is required during development of the heart and lungs to allow blood to bypass the lungs during fetal life when they are collapsed and do not contain air. The ductus arteriosus has a muscular type of wall that causes it to normally close in the first few days of life. In some cases, the ductus arteriosus remains open causing a large amount of blood to flow from the aorta through the ductus arteriosus into the lungs.
Excess blood flow to the lungs through a patent ductus arteriosus causes breathlessness, difficulty with feeding, difficulty gaining weight due to the increased work of breathing and increased rates of chest infections. Sometimes the excess blood flow does not cause symptoms but results in elevation of the blood pressure in the lung arteries.
In premature infants, medication may be used to close the duct. This is only effective in the first few weeks of life and sometimes the ductus may reopen or not fully close. In full-term babies, infants or older children a non-invasive procedure may be performed to plug the duct through a catheter inserted in a leg artery. However, in many cases open surgery is necessary to tie or clip the duct closed, as it is too big for a plug. This is performed by making an incision on the left side of the chest, entering the chest between the ribs and tying or clipping the ductus arteriosus.