How is PDA treated in adults?

Closure of the defect is generally recommended (as long as advanced pulmonary hypertension is not present) because of the high risk for cardiac complications and early death related to PDA. Closing the PDA can reduce complications, restore normal circulation, eliminate symptoms and reduce the risk of death. An open surgical procedure was the standard for decades. In this procedure, the surgeon opens the chest and closes the opening with stitches or permanent titanium clips. Today, adult congenital heart disease experts prefer to reserve an open surgical procedure for those patients with large PDAs. More than 95 percent of PDAs can now be closed by catheter-based techniques.

Patent ductus arteriosus ligation – is indicated in all cases of symptomatic or asymptomatic patent ductus arteriosus, with left-right shunt that does not close spontaneously after drug theraphy. This treatment is done to avoid cardio-pulmonary decompensation, irreversible vascular pulmonary disease or infection. This can be done surgically or videoscopic.

Repairing a PDA in an adult is a more complicated procedure than performing the procedure in children. Adults with PDAs should be under the care of an adult congenital heart disease specialist with experience in treating this particular defect. The specialist will evaluate all considerations, such as the size of the PDA, complications related to the PDA and the patient’s overall health, to make a recommendation on which approach is most likely to have the best outcome.

What is the prognosis after PDA closure?

Closing the PDA restores normal circulation to the heart and reduces the risk of endocarditis, pulmonary hypertension, aneurysm formation and death. But closing the defect may not reverse the damage already done to the heart, such as congestive heart failure, pulmonary vascular disease or calcium deposits at the site of the defect. Endocarditis prophylaxis (antibiotics) is recommended for 6 months following closure of a PDA or for life if any residual defect is present. Patients with repaired PDAs should remain under the care of a cardiologist experienced in adult congenital heart problems.