Patent ductus arteriosus
Patent ductus arteriosus (open arterial canal) – a congenital heart defect that occurs in connection with the closing of the artery wrapped around the pulmonary circulation.
Dr. Anat Birk – specialist in pediatric cardiology. Director of Institute for the Heart Study, Schneider Hospital
Ductus arteriosus is in the blood vessels in the chest of the fetus and connects the pulmonary artery to the aorta bypassing the pulmonary circulation. Its function is to supply oxygen to the blood of mother to child in the womb until his lungs do not work yet and he can not breathe on their own.
In the normal case it is closed after the birth because of its role has been performed. However, in children born very early (28 weeks gestation or less) duct may remain open. In most cases, the presence of small holes in the channel is not shown any symptoms or behavior changes of a child. The problem can be detected by listening to heart murmurs which indicate the flow of blood through the open channels, which can be the result of the development of heart failure.
As a general rule, the closing flow during the first three months of life. Very rarely duct closes itself by passing three months, so that in this case may require surgical intervention. The operation depends on the degree of heart failure.
Drug therapy can be effective only in the first few days after birth. In such situations, typically clinicians recommend aspirin or ibuprofen.
Upon admission to the surgery for children specialist examines child, measures blood pressure, pulse, temperature, weight and growth of the baby. He also collects health information that includes: medical history, presence of previous surgeries, hospitalizations and drug sensitivity. In conclusion, cardiac surgeon explains the operation and respond to parents’ questions.
The anesthesiologist in turn explains the process of anesthesia, gives detailed information about analgesics after surgery.
Before the operation, carried out such tests as: chest X-ray, ECG, echocardiography (if necessary) and blood tests.
The operation is performed under general anesthesia and the baby for a few hours before the operation should not eat. Anesthesia child perceives no contact with the body. Anesthetic drug enters through the mask into the airway of a child or intravenously. One parent can accompany the child to the operating room and stay with it until the baby falls asleep.
If there are no other defects, except for the open flow, the operation is performed by the closed method, through a catheter into a vein and does not require mechanical ventilation. The operation consists in a compound of the blood vessels open (PDA). Continuing operations for about an hour.
After surgery the child is transferred to the intensive care unit for observation. He is there at least a day, but he can stay there longer.
In the absence of any complications baby discharged 6 days after surgery.
Subsequent pain control is carried out with the help of drugs. Highly-trained medical staff provide all necessary assistance for postoperative pain relief, so the children are very relaxed and almost do not not feel pain.
Our experts recommend a gradual return to an active life, in accordance with the instructions of the cardiologist. Parents of children older than one year must be constant monitoring of a number of things over a period of two months after operation due to the very slow recovery of the sternum. Necessary to avoid cycling, ball games, jumping and sudden movements.
Return to a full physical activity should be gradually and under the constant supervision of a cardiologist.
The success of the operation to close the ductus arteriosus – more than 97 percent. The majority of the operations conducted in children premature infants weighing 500 to 700 grams.
As with any surgery in after the closing of the ductus arteriosus can be complications. Heart surgeon and anesthesiologist provide parents with the information about complications.
In most cases, the child can begin to eat 24 to 48 hours after surgery. First meal should be light (drinking), but the child can return to a normal diet very quickly.
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