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
- Cardiac Catheterization
- ECG (Electrocardiogram)
- If Your Child Has a Heart Defect
- A to Z: Atrial Flutter
- A to Z: Tetralogy of Fallot
- A to Z: Patent Ductus Arteriosus (PDA)
- Heart and Circulatory System
- Patent Ductus Arteriosus (PDA)
- A to Z: Hypoplastic Left Heart Syndrome
- Coarctation of the Aorta
- Congenital Heart Defects
- Congenital Heart Defects Special Needs Factsheet
- Tetralogy of Fallot
- Atrial Septal Defect
- Heart Murmurs and Your Child
- When Your Child Needs a Heart Transplant
- Ventricular Septal Defect
Trusted External Resources
A to Z: Tetralogy of Fallot
A to Z: Tetralogy of Fallot
The four specific heart defects that make up tetralogy of Fallot (fah-LO) are:
- ventricular septal defect
- pulmonary valve stenosis (narrowing)
- right ventricular hypertrophy
- overriding aorta
More to Know
Babies with tetralogy of Fallot can have cyanosis, which is a bluish-purple color to their skin, lips, and fingernails. This happens when not enough blood reaches the lungs to get oxygen. They may also fail to gain weight, have difficulty feeding or breathing, and have enlarged skin or bones around the fingernails (known as clubbing).
Tetralogy of Fallot develops in utero while the heart is forming. A specific cause hasn't been determined, but babies with certain genetic disorders are at higher risk for developing it. Other risk factors include advanced maternal age and, during pregnancy, poor nutrition, diabetes, or certain viral illnesses.
Keep in Mind
Tetralogy of Fallot is a serious condition that requires young infants to have heart surgery to repair the defect. The good news is that most babies recover fully and thrive into adulthood. They will, however, need to be monitored closely by a heart specialist for the rest of their lives.
All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts.
Date reviewed: April 28, 2017