How to treat patent ductus arteriosus?

Written by Tang Li
Cardiology
Updated on September 01, 2024
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The arterial duct connects the main pulmonary artery to the descending aorta, serving as the primary channel for blood circulation during the fetal period. After birth, it generally becomes obstructed within a few months due to disuse; if it remains open after one year, it is referred to as patent ductus arteriosus (PDA). The length and diameter of an unclosed arterial duct vary, affecting hemodynamics differently, and consequently, prognoses differ. An unclosed arterial duct can easily induce infectious endocarditis; thus, even if the shunt is small, it is advisable to seek early interventional or surgical treatment. The surgery has a high safety success rate and can be performed at any age. However, surgery is contraindicated for patients who have developed secondary pulmonary artery obstruction and exhibit right-to-left shunting.

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Written by Xie Zhi Hong
Cardiology
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Can a patent ductus arteriosus heal by itself?

The ductus arteriosus is a duct that fetal blood must pass through as it is transported from the placenta to the aorta. This duct connects between the main pulmonary artery and the aorta of the fetus and generally closes on its own after birth. Most patients can close it spontaneously within three months, but the likelihood of closure diminishes if it surpasses one year. Therefore, for patent ductus arteriosus, some people can heal on their own, while others, especially children over one year old, cannot heal by themselves and are advised to undergo surgery as soon as possible. This is because the patent ductus arteriosus can cause a condition similar to an arteriovenous fistula, increasing the workload on the heart, leading to cardiac hypertrophy and eventual heart failure.

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Written by Xie Zhi Hong
Cardiology
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Why does patent ductus arteriosus cause differential cyanosis?

The arterial duct refers to a blood vessel connecting the main pulmonary artery and the aorta, which is normally present during fetal development. It allows blood from the mother's placenta to seep into the pulmonary artery and then enter the aorta to supply the entire body's vasculature. After the birth of an infant, this blood vessel naturally closes, typically within 3 months, and most people will have it closed by 1 year. If it has not closed after 1 year, it is referred to as patent ductus arteriosus. Because the arterial duct can connect the aorta and the main pulmonary artery, blood from the systemic circulation in the aorta may directly return to the pulmonary artery at this time. If the pulmonary artery blood flow significantly increases, it can lead to pulmonary arterial hypertension and might also cause right ventricular hypertrophy. Increased cardiac workload can lead to right-sided heart failure and may also cause left-sided heart failure. When severe left-sided heart failure occurs, a right-to-left shunt can develop, which allows pulmonary artery blood to directly enter the aorta, causing venous blood to be delivered directly into the systemic circulation. At this point, differential cyanosis occurs, characterized by bluish discoloration of the upper limbs and mild blueness in the lower limbs.

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Written by Tang Li
Cardiology
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How to treat patent ductus arteriosus?

The arterial duct connects the main pulmonary artery to the descending aorta, serving as the primary channel for blood circulation during the fetal period. After birth, it generally becomes obstructed within a few months due to disuse; if it remains open after one year, it is referred to as patent ductus arteriosus (PDA). The length and diameter of an unclosed arterial duct vary, affecting hemodynamics differently, and consequently, prognoses differ. An unclosed arterial duct can easily induce infectious endocarditis; thus, even if the shunt is small, it is advisable to seek early interventional or surgical treatment. The surgery has a high safety success rate and can be performed at any age. However, surgery is contraindicated for patients who have developed secondary pulmonary artery obstruction and exhibit right-to-left shunting.

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Written by Di Zhi Yong
Cardiology
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The reasons for ventricular enlargement due to patent ductus arteriosus

Patent ductus arteriosus can lead to enlargement of the anterior heart, as it can cause enlargement of the left atrium, left ventricle, or anterior ventricle, potentially leading to heart failure, especially altering heart function. If a patient has a patent ductus arteriosus, I personally recommend getting an ECG at a hospital early and then determining a treatment plan. Currently, surgical treatment is advised to improve the condition of reduced heart function. During this time, it is still important to actively and regularly monitor changes in the patient’s blood pressure, heart rate, and pulse. If the heart rate is too fast or blood pressure is elevated, regular hospital visits are necessary for management.

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Written by Xie Zhi Hong
Cardiology
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Is patent ductus arteriosus related to staying up late during pregnancy?

The arterial duct refers to a continuous duct between the main trunk of the pulmonary artery and the aorta during the embryonic period of the fetus. Through this duct, blood from the placenta can be delivered to the infant's body for tissue oxygenation. Therefore, the arterial duct is originally a normal tissue in the embryo. After the birth of the infant, the majority of arterial ducts will close within a few months. If it has not closed after one year, it can be diagnosed as congenital patent ductus arteriosus. Therefore, there is no relationship between patent ductus arteriosus and staying up late during pregnancy.