How do you prepare for Patent Ductus Arteriosus treatment ? (Preoperative)

If the doctor suspects a heart defect, he/she will ask you to take the following tests for your child.

Echocardiogram: Sound waves create images of the heart so that the doctor can see if your child’s heart chambers are enlarged and determine how well the heart is pumping. This test is done to evaluate the heart valves and detect other potential heart defects.

Chest X-ray:  This test is done to get an X-ray image of your child’s heart and lungs and further identify conditions other than a heart defect.

Electrocardiogram: This test is done to record electrical activity of your child’s heart and diagnose heart defects and rhythm problems.

Cardiac catheterization: This test is done to examine and diagnose congenital heart defects found during an echocardiogram. A thin, flexible tube (catheter) is inserted into a blood vessel present at your child’s groin or arm and guided through into the heart. Through this method of catheterization, your child’s doctor can initiate procedures to close the patent ductus arteriosus.  

What happens during patent ductus arteriosus treatment process? (During the process)

Surgical closure: Two forms of surgical therapy are performed to treat Patent Ductus Arteriosus: a) the traditional surgical approach, which entails a thoracotomy (or alternatively, thoracoscopy), and b) catheter closure.

Thoracotomy:In this procedure,  a surgeon will make a small cut between your child's ribs to reach your child's heart and repair the open duct using stitches or clips. Your child will be given general anesthesia, with selective right lung intubation, and placed in the right lateral decubitus position. A left upper extremity pulse oximeter will be placed to monitor  left subclavian artery occlusion. Four 3-5mm thoracostomy ports will be placed. A camera port is placed just below the scapula in the intercostal space, a lung retractor port is placed between the mid and posterior axillary line, a working port behind the scapular edge and halfway between the midline of the back, and a grasper port will be placed over the rib. All four ports sites will be  injected generously with a local anesthetic, and closed with absorbable sutures and dressed.

Catheter Closure: Catheter procedures are used to treat full-term babies, children and adults. In catheter closure procedure, a thin tube (catheter) will be inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil will be  inserted to close the ductus arteriosus.

What can you expect after PDA surgery? (Postoperative)

• Your child will experience some pain and discomfort in the surgical site
• Your child’s pulse rate and skin temperature will be continuously monitored
• Your child may go home in two days after surgery. However, premature infants usually have to stay in the hospital longer because of their other health issues.
• You will be advised to limit your child’s physical activity for some days to speed up the recovery process

What are the risks and complications associated with PDA surgery? (Risks)

• Bleeding
• Infection
• Vocal cord Paralysis
• Pneumothorax

Lifestyle changes:

• You will need to put a limit on your child’s physical activities while he or she recovers
• You will be advised to include fibre and vitamin rich food in your child’s diet

Key Terminologies:

Pneumothorax: It is a condition that occurs when lungs collapse.  A pneumothorax occurs when air leaks into the space between your lung and chest wall