Babies and children with patent ductus arteriosus (PDA) receive care from our team with expertise in device closure of PDA, including specialized care for babies born prematurely.

For babies and children with patent ductus arteriosus (PDA) — an opening between the pulmonary artery and the aorta that allows blood to flow directly from the heart to the lungs — a cardiac catheterization procedure can close the defect and alleviate symptoms like difficulty breathing and improve growth.

The expert interventional cardiology team at Johns Hopkins All Children’s in St. Petersburg, Florida, specializes in using catheter procedures to close PDA in even very small premature babies so that they can thrive. Babies and children also generally have a much shorter recovery time after catheter procedures.

What is patent ductus arteriosus (PDA)?

Before birth, babies do not need to use their lungs to take in oxygen because they receive oxygen from their mother. Since they aren’t using their lungs, the heart doesn’t need to pump blood to the lungs yet.

Because of this, before birth every baby has an artery — called the ductus arteriosus — that is open to allow the fetus to send blood directly back to the placenta to pick up oxygen from the mother. This artery typically closes soon after birth, allowing blood to flow directly from the heart to the lungs.

When this artery does not close after birth, this is called a patent ductus arteriosus (PDA), which is a congenital heart defect (“congenital” means it is present at birth). With PDA, oxygenated blood returns directly to the lungs instead of circulating through the rest of the body, causing the heart and lungs to work harder and create difficulty breathing.

Symptoms of patent ductus arteriosus

Symptoms vary depending on the size of the opening. A smaller opening may not cause any symptoms and may be detected later if your child’s doctor hears a heart murmur in your child. A large opening can cause signs of heart failure shortly after birth.

In those babies and children who do show symptoms, symptoms may include:

• Difficulty breathing
• Fast breathing
• Respiratory infection
• Tire more easily
• Trouble feeding
• Poor growth

It's not known what causes PDA, but it occurs most often in babies born prematurely, and can be associated with other heart defects. With certain heart defects, the opening caused by the PDA allows adequate blood flow to the body despite the additional defect.

How is patent ductus arteriosus diagnosed?

In children who have PDA without an additional defect, a heart murmur and symptoms of heart failure such as difficulty breathing and poor growth may point to PDA. Tests used to diagnose PDA include echocardiogram (an ultrasound of the heart) and chest X-ray.

In children who have PDA with an additional associated defect, a cardiac catheterization procedure (in which a small, thin tube is guided into the heart to examine the structure of the heart) may be needed for diagnosis.

Treatment for patent ductus arteriosus

Treatment depends on factors like your child’s age, symptoms and size of the defect. If your child’s PDA is small and they have no symptoms of heart failure, our team may monitor to allow time for the defect to close on its own.

For babies and children who require treatment to close the PDA, we use cardiac catheterization to close the defect with a small device. The interventional cardiologist guides a long, thin tube called a catheter through the blood vessels (usually through a tiny incision in the groin area, neck or wrist), using imaging to guide the catheter and place the device that will close the hole.

For premature babies, we have expertise in using a specialized device — the FDA-approved Amplatzer Piccolo Occluder — to treat their PDA. Using a catheter to insert the Piccolo allows us to close it and improve blood flow in babies as small as 1½ pounds without surgery.

It is usually done within the first few weeks of life, and evidence shows that babies recover quicker from this procedure compared to previously performed surgical repair for PDA in premature babies. This also helps to avoid the negative side effects that can occur from treatment with medication.

Why Choose Johns Hopkins All Children’s

The cardiac catheterization program at Johns Hopkins All Children’s is led by James Thompson, M.D., a national leader and early adopter in using the most advanced cardiac catheterization methods and technology to treat PDA in babies as small as 650 grams. He also teaches other physicians how to use this technology. Learn more about our Interventional Cardiology Program.

The Heart Institute team includes experts in all aspects of cardiac care for children and adults with congenital heart defects, so your child can receive comprehensive care from our team through adulthood. Learn more about our Cardiology Program.