Last week, our indigenous catheterization team headed by our interventional pediatric cardiologist performed a device closure of a large patent ductus arteriosus in a 30-year-old lady. She was admitted a day before the procedure and discharged 24 hours after the procedure without any complications; giving a total hospital stay of fewer than 3 days. The patient has been reviewed a week after the procedure and is set to return to work. Patent Ductus Arteriosus (PDA) is a congenital heart condition characterized by an abnormal connection between the large artery serving the body (aorta) and the artery to the lungs (pulmonary artery). Every child is born with a connection between the pulmonary artery and the aorta called a ductus arteriosus; but after the first breath, the ductus arteriosus is no longer necessary and usually closes within a couple of days after birth. It is called a patent ductus arteriosus, or PDA if it does not close as expected. This defect causes abnormally excessive blood flow to the lungs which makes the child’s heart and lungs work harder. In the pulmonary arteries, extra blood flow through the PDA can increase lung pressures over time; damaging the lungs as well as the heart. PDA closure can be achieved in two ways: First is by surgical ligation which involves tying up the duct through an incision extending from the left side of the back to below the left armpit and second is by device closure through a minimally invasive technique called cardiac catheterization performed without a surgical incision. The end goal of ligation or device closure of the PDA is to eliminate excessive blood flow to the lungs and create a normal flow of blood through the body.
PDA device closure procedure begins with the insertion of a short sheath into a major blood vessel in the patient’s groin. Through this sheath, a soft flexible tube called a catheter is inserted into the major blood vessel called the aorta, and dye is injected within it to outline the defect. This injection is viewed as an x-ray image, called an angiogram, the PDA is measured and an appropriately sized device is selected. The doctor will guide the device attached to a cable through a long sheath. The device is placed firmly across the defect and the cable is detached. To ensure no blood flows through the PDA, the device is re-evaluated using another angiogram. The cable, catheter, and sheath are removed at the end of the procedure while only the device remains in the patient. This device is not harmful and over time will become incorporated into the structures around it.
Every patient is distinct; but globally, device closure is a preferred option for PDA occlusion in all age groups and we at the Heart Centers at Tristate Healthcare System are dedicated to the unique needs of our patients. At Tristate Healthcare System, we have the local expertise to support you and your loved ones through the entire journey of this minimally invasive procedure to get our patients up and running like “nothing happened”! At any time, at Tristate Healthcare System, we are available to answer all your questions.