Significance of the Patent Ductus Arteriosus in Neonates

The patent ductus arteriosus (PDA) is the most common abnormal cardiac finding in neonates. Persistent patency of the ductus arteriosus may be encountered in three different situations: Persistent ductus arteriosus in term newborns, persistent ductus arteriosus in preterm newborns and persistent ductus arteriosus in children with congenital heart disease. Problems associated with PDA include feeding intolerance, necrotizing enterocolitis (NEC), metabolic acidosis, renal failure, peri/intraventricular hemorrhage (PVH/IVH), pulmonary hemorrhage (PH), chronic lung disease (CLD) and death. The use of multimodal technologies can provide assessment of the impact of hemodynamically significant PDA (hs-PDA) including: echocardiography, serum biomarker level (BNP, NT pro BNP, cTnT), NIRS (Near infrared spectroscopy). Determining the degree of shunting can be helpful in making a decision about the need for therapeutic intervention. The goal of treatment in congenital heart diseases with ductus dependent systemic and pulmonary circulation is to re-establish the prenatal circulation pattern before final, hybrid or palliative surgical treatment.

Keywords: hemodynamically significant patent ductus arteriosus, neonate, congenital heart disease.