What will happen if patent ductus arteriosus is not treated with surgery?

Written by Xie Zhi Hong
Cardiology
Updated on December 24, 2024
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Patients with patent ductus arteriosus are characterized by a congenital connection between the pulmonary artery and the aortic arch. This is a remnant passageway that was used during embryonic development to supply blood within the umbilical vessels, ensuring the development of the infant. Normally, this ductus arteriosus may close on its own within a few months. If it does not close after one year from birth, it is considered a patent ductus arteriosus. This condition can lead to increased workload on the heart. Because it allows blood pumped into the aorta to return to the right ventricle, over time, this can increase the burden on the left ventricle as well as the right ventricle. This may lead to heart failure and, in severe cases, trigger Eisenmenger's syndrome. If this condition reaches such a state, the patient loses the opportunity for surgery, resulting in a shortened lifespan.

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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 Xie Zhi Hong
Cardiology
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Can you get pregnant with patent ductus arteriosus?

Patent ductus arteriosus refers to a congenital channel between the aorta and the pulmonary artery that fails to close. This can lead to a mixing of blood between the veins and arteries, thus deteriorating heart function. Generally, individuals with this condition can become pregnant after treatment. Patent ductus arteriosus is a congenital heart defect that does not have hereditary properties and does not prevent one from having children. However, it is advised for individuals with this condition to undergo surgical treatment before attempting to conceive and bear children. If the ductus arteriosus remains untreated, the increased heart load during late pregnancy can cause symptoms such as difficulty breathing and respiratory distress. It is recommended that these individuals undergo minimally invasive surgical treatment or conventional surgical treatment before planning for pregnancy, as this will be more appropriate.

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Written by Tang Li
Cardiology
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Why does patent ductus arteriosus cause a decrease in diastolic pressure?

In patients with patent ductus arteriosus, since the aortic pressure is significantly higher than the pulmonary artery pressure throughout the cardiac cycle, there is continuous blood flow from the aorta into the pulmonary artery through the open duct, causing a left-to-right shunt. This increases the blood volume in the pulmonary circulation, causing dilatation of the pulmonary artery and its branches. The blood flow returning to the left heart system also increases, thereby increasing the load on the left heart and causing the left heart to enlarge. Due to the diastolic diversion of blood from the aorta to the pulmonary artery, the peripheral arterial diastolic pressure decreases and the pulse pressure increases.

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Written by Xie Zhi Hong
Cardiology
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Can patent ductus arteriosus be treated with medication?

The ductus arteriosus is a blood vessel connecting the pulmonary artery to the aorta in the fetal heart, primarily used during the embryonic stage to supply blood from the mother to the heart, thus providing sufficient oxygenated blood for fetal development and growth. Generally, the ductus arteriosus should close automatically within three months after birth. If it remains open for over a year, it may indicate a congenital heart defect known as patent ductus arteriosus. Previously, high doses of aspirin were used to treat this condition, but this treatment was not very effective. Patients with patent ductus arteriosus should instead consider minimally invasive interventional treatments to seal the duct, or surgical ligation can be performed. However, surgical ligation may cause significant trauma or scarring to the patient. The majority of cases with patent ductus arteriosus can be treated using minimally invasive methods.

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Written by Xie Zhi Hong
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Can a patent ductus arteriosus be treated with minimally invasive surgery?

Patent ductus arteriosus refers to the condition in infants where the ductal connection between the pulmonary artery and the aortic arch from the embryonic period remains open after the first year of birth. Generally, this duct is tubular or funnel-shaped and most cases can be treated minimally invasively. Surgical treatment is considered only if there are severe adhesions involving the aorta or pulmonary artery, or there are developmental issues. Therefore, patent ductus arteriosus can be treated with minimally invasive surgery, and most cases are amenable to such treatment.