Patent Ductus Arteriosus: Investigations, and Treatment
Omar Elsaka *
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Managing persistent patent ductus arteriosus (PDA) is still a difficult task. During the previous 20 years, the attitude regarding PDA has evolved in the other way, from pushing for an aggressive and early closure to a demand for careful observation. While persistent PDA can complicate preterm neonatal medical management due to fluid overload, pulmonary edema or hemorrhage, hypotension, and decreased tissue perfusion, it can also contribute to long-term neonatal morbidities such as bronchopulmonary dysplasia (BPD). It is now apparent that the majority of PDA cases close spontaneously and do not require treatment, as long as conservative management is used. However, there has been little consensus on what defines a hemodynamically significant PDA and when, if ever, it should be treated. With growing worry about the potential risks of PDA ligation, a new method for transcatheter PDA closure is gaining traction. We describe current knowledge of the pathogenesis, diagnosis, and therapy of PDA in preterm newborns in this review, and give some evidence-based recommendations.
Conclusion: Fluid restriction and diuretics (where clinically appropriate), medicinal intervention, and surgical ligation are the three current therapy options for PDA.
Keywords: Cyclooxygenase inhibitors, ibuprofen lysine, indomethacin, non-steroidal anti-inflammatory drugs, patent ductus arteriosus, prostaglandins