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Patent Ductus Arteriosus
Randy R. Richardson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Patent ductus arteriosus (PDA)
          • Synonyms

            • Persistent arterial duct, patent ductus Botalli
          • Definitions

            • Persistent postnatal patency of normal prenatal connection from pulmonary artery (PA) to proximal descending aorta
            • Category: Acyanotic, ↑ pulmonary blood flow
            • Hemodynamics: L → R shunt between aorta & PA
            • PDA is frequently essential part of complex congenital heart disease
              • Typical ductal-dependent lesions, including hypoplastic left heart syndrome, severe hypoplastic-type coarctation, & interruption of aortic arch: Conduit for systemic perfusion (R → L flow)
              • D-transposition of great arteries: Necessary for admixture between systemic & pulmonary circuits (L → R flow)
              • Pulmonary atresia & other severe cyanotic heart diseases with right-sided obstruction: Conduit for pulmonary perfusion (L → R flow)
            • PDA is part of persistent fetal circulation syndrome: R → L flow
              • Severe lung disease (meconium aspiration, surfactant deficiency disease, neonatal pneumonia)
              • Primary pulmonary hypertension of neonate

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Echocardiographic Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. El-Khuffash A et al: A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr. 167(6):1354-1361.e2, 2015
                                      2. Ryan JJ et al: Eisenmenger syndrome with unrepaired patent ductus arteriosus. Circulation. 131(16):e409-11, 2015
                                      3. Anilkumar M: Patent ductus arteriosus. Cardiol Clin. 31(3):417-30, 2013
                                      4. Broadhouse KM et al: Assessment of PDA shunt and systemic blood flow in newborns using cardiac MRI. NMR Biomed. 26(9):1135-41, 2013
                                      5. Brunetti MA et al: Percutaneous closure of patent ductus arteriosus: a multiinstitutional registry comparing multiple devices. Catheter Cardiovasc Interv. 76(5):696-702, 2010
                                      6. Thai WE et al: Dynamic volume 320-slice CT in the assessment of patent ductus arteriosus for percutaneous closure. Heart. 96(4):321, 2010
                                      7. Debl K et al: Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry. Br J Radiol. 82(977):386-91, 2009
                                      8. Schneider DJ et al: Patent ductus arteriosus. Circulation. 114(17):1873-82, 2006
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Patent ductus arteriosus (PDA)
                                              • Synonyms

                                                • Persistent arterial duct, patent ductus Botalli
                                              • Definitions

                                                • Persistent postnatal patency of normal prenatal connection from pulmonary artery (PA) to proximal descending aorta
                                                • Category: Acyanotic, ↑ pulmonary blood flow
                                                • Hemodynamics: L → R shunt between aorta & PA
                                                • PDA is frequently essential part of complex congenital heart disease
                                                  • Typical ductal-dependent lesions, including hypoplastic left heart syndrome, severe hypoplastic-type coarctation, & interruption of aortic arch: Conduit for systemic perfusion (R → L flow)
                                                  • D-transposition of great arteries: Necessary for admixture between systemic & pulmonary circuits (L → R flow)
                                                  • Pulmonary atresia & other severe cyanotic heart diseases with right-sided obstruction: Conduit for pulmonary perfusion (L → R flow)
                                                • PDA is part of persistent fetal circulation syndrome: R → L flow
                                                  • Severe lung disease (meconium aspiration, surfactant deficiency disease, neonatal pneumonia)
                                                  • Primary pulmonary hypertension of neonate

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Echocardiographic Findings

                                                        • Angiographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. El-Khuffash A et al: A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr. 167(6):1354-1361.e2, 2015
                                                                          2. Ryan JJ et al: Eisenmenger syndrome with unrepaired patent ductus arteriosus. Circulation. 131(16):e409-11, 2015
                                                                          3. Anilkumar M: Patent ductus arteriosus. Cardiol Clin. 31(3):417-30, 2013
                                                                          4. Broadhouse KM et al: Assessment of PDA shunt and systemic blood flow in newborns using cardiac MRI. NMR Biomed. 26(9):1135-41, 2013
                                                                          5. Brunetti MA et al: Percutaneous closure of patent ductus arteriosus: a multiinstitutional registry comparing multiple devices. Catheter Cardiovasc Interv. 76(5):696-702, 2010
                                                                          6. Thai WE et al: Dynamic volume 320-slice CT in the assessment of patent ductus arteriosus for percutaneous closure. Heart. 96(4):321, 2010
                                                                          7. Debl K et al: Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry. Br J Radiol. 82(977):386-91, 2009
                                                                          8. Schneider DJ et al: Patent ductus arteriosus. Circulation. 114(17):1873-82, 2006