What you need to know about:

Patent Ductus Arteriosus Ligation

Fast Fact

84%
Worth It Rating
Average Cost:
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Recovery Period:
Several weeks
Permanence:
Depends on patient condition.
177
Doctors
Time it takes:
1-3 hours
96
Hospitals & Clinics
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Anesthetize:
General anesthesia

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Overview of

Patent Ductus Arteriosus Ligation

in Thailand

Patent ductus arteriosus (PDA) ligation is a corrective surgical procedure for children whose ductus arteriosus does not close after birth. The ductus arteriosus is a blood vessel joining the pulmonary artery (main artery to the lungs) to the aorta (main artery to the body). In the fetal heart, blood bypasses the lungs and gets oxygen from the placenta. When the newborn’s lungs take over at birth, the body stops producing the chemicals that keep the ductus arteriosus open, and it closes naturally. If it fails to close, a patent or open ductus arteriosus occurs, resulting in too much blood flowing to the lungs. If the patent ductus arteriosus is large, it may cause poor eating and growth, fast breathing, easy tiring, rapid heart rate, and frequent lung infections. The goal of treatment is to close the patent ductus arteriosus to prevent complications and reverse the effects of the increase in blood volume.

Goals of

Patent Ductus Arteriosus Ligation

A PDA ligation is performed when medical treatment fails. This procedure is performed in order to close and tie off the PDA and restore the normal blood flow in the infant's heart.

Price of

Patent Ductus Arteriosus Ligation

Average Cost

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Price Range

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Pros and cons of

Patent Ductus Arteriosus Ligation

Pros

-Surgery which allows the closure of PDAs, offers a definitive approach to treating this condition

Cons

-Risks that come with surgery

How It Works:

Patent Ductus Arteriosus Ligation

During the procedure, the patient will be under general anesthesia. The surgeon will make a small incision on the left side of the chest in between the ribs. Once the surgeon reaches the patent ductus arteriosus, the open duct will be repaired with stitches or clips. Once the ligation is complete, the surgeon closes the wound

Preparation before

Patent Ductus Arteriosus Ligation

Pre - treatment

The patient will be prepared for physical cleanliness, and refrain from wearing any metallic ornaments, holy threads and nail lacquer. Stop some medications at least 7-10 days before operation such as aspirin or some heart medicines which will be instructed by the physician. Inform the physician if the patient or siblings have a record of easy bleeding, difficult blood clotting or bruise on the body. The operation should be pending if the patient has a cold or fever. If the patient has tooth decay, please see the dentist before undergoing the operation to avoid the risk of respiratory and heart infections. Small children and children with cyanosis are excluded as they might encounter complications during dental treatment. The patient should refrain from food and drink according to the anesthetist’s scheme.

Recovery after

Patent Ductus Arteriosus Ligation

Post - treatment

After surgery, the patient will be in an intensive care unit. A number of systems are used to monitor the patient's heart rate and rhythm, blood pressure, temperature, and breathing rate. Monitoring is gradually discontinued as the person recovers. The patient will be expected to be in the hospital about one week. Before leaving the hospital, the family will be instructed on how to care for their child at home. This includes information on medications, caring for the incision, and activity limitations. Within a few weeks, the child should fully recover and be able to take part in normal activities. After successful surgery, children generally do not have any symptoms and lead normal lives. Let the doctor know if the patient develops problems, such as: Bleeding or swelling at the incision site Signs of infection such as redness, drainage, or fever Chest pain or shortness of breath

Risks & side effects

The risks of patent ductus arteriosus ligation include the following:  

-Bleeding

-Infection

-Paralyzed diaphragm (muscle below the lungs)

-Adverse reaction to medication

-Arrhythmias (irregular heartbeat)

-Damage to blood vessels

-Fluid around the lungs

FAQs:

Patent Ductus Arteriosus Ligation

What is PDA?

Patent ductus arteriosus (PDA) is a heart defect found in the days or weeks after birth. The ductus arteriosus is a normal part of fetal blood circulation before a baby is born. It’s an extra blood vessel that connects 2 arteries: the pulmonary artery and the aorta. The pulmonary artery carries blood from the heart to the lungs. The aorta carries blood from the heart to the body. Before birth, the ductus arteriosus lets blood go around (bypass) the lungs. This is because the baby gets oxygen from the mother.  All babies are born with this opening between the aorta and the pulmonary artery. But it often closes on its own shortly after birth, once the baby breathes on its own. If it stays open (patent), it is called patent ductus arteriosus. With PDA, extra blood flows to the lungs. If the PDA is large, too much blood goes to the lungs. The blood vessels and the lungs have to work much harder to handle the extra blood. This can lead to fluid buildup in the lungs. The baby can have a harder time breathing and feeding.

What are the symptoms of PDA?

The size of the opening between the aorta and the pulmonary artery will affect symptoms. If your baby has a small opening, he or she may not have symptoms. If your baby has a larger opening, he or she may have symptoms. These are the most common symptoms of PDA:  Skin turns a blue color from not getting enough oxygen (cyanosis)  Very tired  Fast or hard breathing  Trouble feeding, or tiredness while feeding  Infections  Poor weight gain  In older children, trouble doing activities  The symptoms of PDA can seem like other health conditions. Have your child see his or her healthcare provider for a diagnosis.

What other approaches can be used to treat patients with PDA?

1. Medicines Your baby may need medicines help the heart work better. In premature infants, the medicine indomethacin may help close the PDA. Indomethacin stimulates the muscles inside the PDA to tighten. This closes the connection. Some babies may need medicine to help the heart and lungs work better. Sometimes a baby may need medicine such as diuretics (water pills). Diuretics help the kidneys remove extra fluid from the body. This may be needed when the heart is not working well. Or it may be needed if the blood vessels in the lungs have to make room for more blood flow, as with a PDA.  2. Nutrition Most infants with PDA eat and grow normally. Some premature infants or those infants with large PDAs may get tired when feeding. They may not be able to eat enough to gain weight. Nutrition choices include:   -High-calorie supplements. Special nutritional supplements may be added to formula or pumped breastmilk to increase the number of calories. Your baby can drink less and still have enough calories to grow correctly. -Supplemental tube feedings. Supplemental feedings are given through a small, flexible tube. The tube passes through the nose, down esophagus, and into the stomach. The feedings can either be added to or take the place of bottle-feedings. Infants who can drink part of their bottles, but not all, may be fed the rest through the feeding tube. Babies who are too tired to bottle-feed may get all of their formula or breastmilk through the feeding tube.  3. Therapeutic cardiac catheterization  Your doctor will insert a thin, flexible tube (catheter) into a blood vessel in the groin. He or she will guide it through the large blood vessel in the groin to the area of the PDA. The catheter will be placed in the PDA. Dye may be injected at this time to help the provider put the catheter in the right place. A coil or closure device which is attached to the catheter will then be placed in the PDA. This will stop blood from flowing through the PDA. Once the coil or device is in the correct position, it will be released from the catheter. Then the catheter will be removed Typically this method is used if a child: is older than 6 months, is at least 22 pounds, and has defects that are not too large

When is surgery advised for the treatment of PDA?

Surgery can close PDAs. Surgical closure is often advised for babies younger than 6 months who have large defects and symptoms such as poor weight gain and fast breathing. For babies who don't have symptoms, any surgery may be delayed until after age 6 to 12 months. Your child's cardiologist will advise when the surgery should be done. It is done under general anesthesia so you child will be asleep. Surgery closes the PDA with stitches or clips. This stops the extra blood from getting into the lungs. Premature babies must have this surgery.

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