The ductus arteriosus is a normal connection in utero between the pulmonary artery and the aorta. Since the lungs are still developing, the baby receives oxygenated blood from the mother during pregnancy. The ductus arteriosus allows the greater part of the oxygenated blood to bypass the non-aerated lungs by flowing directly from the pulmonary artery to the aorta. After the baby is born and begins breathing, hormonal changes occur causing the ductus arteriosus to close. A patent ductus arteriosus, or PDA, is when this connection does not close as it normally should. If the ductus remains open, the direction of flow reverses and some of the oxygen-rich blood from the aorta flows to the pulmonary artery and into the lungs. This may cause an excessive amount of blood flow to the lungs.
There are two reasons that necessitate the closure of a PDA. The first is the size of the ductus, which in turn determines the volume of extra blood being directed to the lungs. A large volume overload may result in enlargement of the heart and over time heart failure. The second reason is to avoid the risk of developing an infection in the heart known as endocarditis. Approximately, one-eighth of patients with a PDA will develop endocarditis. This increases mortality by 50% whereas the risk of surgery is almost zero.
Depending on the size of the ductus, a PDA may be treated in one of two ways. If the ductus is large, the child may require surgery that involves closing off the ductus with a clamp or suture. However, in many cases, the PDA can be closed using a spring coil or a synthetic plug. Both devices are introduced through a heart catheter, which is passed through a vein in the leg that leads up to the heart.
How Does Patent Ductus Arteriosus (PDA) Differ From Normal Cardiac Anatomy?
If your child has patent ductus arteriosus (PDA) or another congenital heart defect, there's usually something wrong with the structure of his or her heart.
Heart with Normal Cardiac Anatomy
When your child has a congenital heart defect, there's usually something wrong with the structure of his or her heart's structure.
The heart is composed of four chambers. The two upper chambers, known as atria, collect blood as it flows back to the heart. The two lower chambers, known as ventricles, pump blood with each heartbeat to the two main arteries (the pulmonary artery and the aorta). The septum is the wall that divides the heart into right and left sides. The atrial septum separates the right and left atria; likewise, the ventricular septum separates the two ventricles.
There are four valves that control the flow of blood through the heart. These flap-like structures allow blood to flow in only one direction. The tricuspid and mitral valves, also known as the atrioventricular valves, separate the upper and lower chambers of the heart. The aortic and pulmonary valves, also known as the arterial valves, separate the ventricles from the main arteries. Oxygen-depleted blood returns from the body and drains into the right atrium via the superior and inferior vena cavas. The blood in the right atrium then passes through the tricuspid valve and enters the right ventricle.
Next, the blood passes through the pulmonary valve, enters the pulmonary artery, and travels to the lungs where it is replenished with oxygen. The oxygen-rich blood returns to the heart via the pulmonary veins, draining into the left atrium. The blood in the left atrium passes through the bicuspid, or mitral, valve and enters the left ventricle.
Finally, the oxygen-rich blood flows through the aortic valve into the aorta and out to the rest of the body.
From Nemours' KidsHealth
- ECG (Electrocardiogram)
- Cardiac Catheterization
- A to Z: Hypoplastic Left Heart Syndrome
- A to Z: Atrial Flutter
- Atrial Septal Defect
- If Your Child Has a Heart Defect
- When Your Child Needs a Heart Transplant
- A to Z: Tetralogy of Fallot
- Tetralogy of Fallot
- A to Z: Patent Ductus Arteriosus (PDA)
- Heart Murmurs and Your Child
- Patent Ductus Arteriosus (PDA)
- Coarctation of the Aorta
- Congenital Heart Defects
- Heart and Circulatory System
- Congenital Heart Defects Special Needs Factsheet
- Ventricular Septal Defect
Trusted External Resources
A to Z: Hypoplastic Left Heart Syndrome
A to Z: Hypoplastic Left Heart Syndrome
May also be called: HLHS
Hypoplastic (HI-puh-plas-tik) left heart syndrome (HLHS) is a rare and serious defect in which the structures of the left side of the heart (the left ventricle, the mitral valve, and the aortic valve) are underdeveloped. As a result, blood cannot be adequately pumped throughout the body.
More to Know
Hypoplastic left heart syndrome is present at birth (congenital) and has no known cause. It is usually diagnosed within the first few days of life. Without surgery to repair the heart, HLHS is fatal.
Symptoms of HLHS include blue or gray skin color (cyanosis), rapid breathing, pounding heart, shortness of breath, cold hands and feet, weak pulse, unusual drowsiness and poor feeding.
Once diagnosed with HLHS, most babies will undergo a series of three operations beginning shortly after birth and ending at 3 years of age. For some babies, heart transplant is the best option if a donated organ is available.
Keep in Mind
While many babies now survive HLHS, they need to be monitored closely by a cardiologist for the rest of their lives. Many complications can occur with HLHS and sometimes additional heart surgery or even heart transplant may be necessary as children born with HLHS get older.
All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts.
Date reviewed: April 28, 2017