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Patent Ductus Arteriosus
Suhny Abbara, MD, FACR, FSCCT; Justin Stowell, MD; Christopher M. Walker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Patent ductus arteriosus (PDA)
              • Synonyms

                • Persistent arterial duct, patent ductus Botalli, patent Botallo duct
              • Definitions

                • Persistence of normal prenatal connection between proximal left pulmonary artery (PA) to aortic isthmus beyond 3 months of life
                • Category: Acyanotic, increased pulmonary blood flow
                • Hemodynamics: L → R shunt between aorta and PA
                • PDA is frequently essential part of complex congenital heart disease
                  • Hypoplastic left heart syndrome, preductal coarctation, interrupted aortic arch: Conduit for systemic perfusion (R → L flow)
                  • Pulmonary atresia and other severe cyanotic heart diseases with right-sided obstruction: Conduit for pulmonary perfusion (L → R flow)
                  • D-transposition: Necessary for admixture between systemic and pulmonary circuits (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

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Reporting Tips

                                              Selected References

                                              1. Agrawal H et al: New patent ductus arteriosus closure devices and techniques. Interv Cardiol Clin. 8(1):23-32, 2019
                                              2. Slaughter JL et al: Comparative Effectiveness of Nonsteroidal Anti-inflammatory Drug Treatment vs No Treatment for Patent Ductus Arteriosus in Preterm Infants. JAMA Pediatr. 171(3):e164354, 2017
                                              3. García-Montes JA et al: Closure of large patent ductus arteriosus using the Amplatzer Septal Occluder. Cardiol Young. 25(3):491-5, 2015
                                              4. Lam JY et al: Treatment options for pediatric patent ductus arteriosus: Systematic review and meta-analysis. Chest. 148(3):784-93, 2015
                                              5. Baruteau AE et al: Transcatheter closure of patent ductus arteriosus: past, present and future. Arch Cardiovasc Dis. 107(2):122-32, 2014
                                              6. Wang K et al: Catheterization therapy vs surgical closure in pediatric patients with patent ductus arteriosus: a meta-analysis. Clin Cardiol. 37(3):188-94, 2014
                                              7. Anilkumar M: Patent ductus arteriosus. Cardiol Clin. 31(3):417-30, 2013
                                              8. Rajiah P et al: Cardiac MRI: Part 1, cardiovascular shunts. AJR Am J Roentgenol. 197(4):W603-20, 2011
                                              9. Kimura-Hayama ET et al: Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 30(1):79-98, 2010
                                              10. Goitein O et al: Incidental finding on MDCT of patent ductus arteriosus: use of CT and MRI to assess clinical importance. AJR Am J Roentgenol. 184(6):1924-31, 2005
                                              11. Morgan-Hughes GJ et al: Morphologic assessment of patent ductus arteriosus in adults using retrospectively ECG-gated multidetector CT. AJR Am J Roentgenol. 181(3):749-54, 2003
                                              12. Wang ZJ et al: Cardiovascular shunts: MR imaging evaluation. Radiographics. 23 Spec No:S181-94, 2003
                                              13. Krichenko A et al: Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol. 63(12):877-80, 1989
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Patent ductus arteriosus (PDA)
                                                          • Synonyms

                                                            • Persistent arterial duct, patent ductus Botalli, patent Botallo duct
                                                          • Definitions

                                                            • Persistence of normal prenatal connection between proximal left pulmonary artery (PA) to aortic isthmus beyond 3 months of life
                                                            • Category: Acyanotic, increased pulmonary blood flow
                                                            • Hemodynamics: L → R shunt between aorta and PA
                                                            • PDA is frequently essential part of complex congenital heart disease
                                                              • Hypoplastic left heart syndrome, preductal coarctation, interrupted aortic arch: Conduit for systemic perfusion (R → L flow)
                                                              • Pulmonary atresia and other severe cyanotic heart diseases with right-sided obstruction: Conduit for pulmonary perfusion (L → R flow)
                                                              • D-transposition: Necessary for admixture between systemic and pulmonary circuits (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

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Agrawal H et al: New patent ductus arteriosus closure devices and techniques. Interv Cardiol Clin. 8(1):23-32, 2019
                                                                                          2. Slaughter JL et al: Comparative Effectiveness of Nonsteroidal Anti-inflammatory Drug Treatment vs No Treatment for Patent Ductus Arteriosus in Preterm Infants. JAMA Pediatr. 171(3):e164354, 2017
                                                                                          3. García-Montes JA et al: Closure of large patent ductus arteriosus using the Amplatzer Septal Occluder. Cardiol Young. 25(3):491-5, 2015
                                                                                          4. Lam JY et al: Treatment options for pediatric patent ductus arteriosus: Systematic review and meta-analysis. Chest. 148(3):784-93, 2015
                                                                                          5. Baruteau AE et al: Transcatheter closure of patent ductus arteriosus: past, present and future. Arch Cardiovasc Dis. 107(2):122-32, 2014
                                                                                          6. Wang K et al: Catheterization therapy vs surgical closure in pediatric patients with patent ductus arteriosus: a meta-analysis. Clin Cardiol. 37(3):188-94, 2014
                                                                                          7. Anilkumar M: Patent ductus arteriosus. Cardiol Clin. 31(3):417-30, 2013
                                                                                          8. Rajiah P et al: Cardiac MRI: Part 1, cardiovascular shunts. AJR Am J Roentgenol. 197(4):W603-20, 2011
                                                                                          9. Kimura-Hayama ET et al: Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 30(1):79-98, 2010
                                                                                          10. Goitein O et al: Incidental finding on MDCT of patent ductus arteriosus: use of CT and MRI to assess clinical importance. AJR Am J Roentgenol. 184(6):1924-31, 2005
                                                                                          11. Morgan-Hughes GJ et al: Morphologic assessment of patent ductus arteriosus in adults using retrospectively ECG-gated multidetector CT. AJR Am J Roentgenol. 181(3):749-54, 2003
                                                                                          12. Wang ZJ et al: Cardiovascular shunts: MR imaging evaluation. Radiographics. 23 Spec No:S181-94, 2003
                                                                                          13. Krichenko A et al: Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol. 63(12):877-80, 1989