Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2022 Sep 3

PMID 36056734

Authors

Carl H Backes

Kevin D Hill

Elaine L Shelton

Jonathan L Slaughter

Tamorah R Lewis

Dany E Weisz

May Ling Mah

Shazia Bhombal

Charles V Smith

Patrick J McNamara

William E Benitz

Vidu Garg

Affiliations

Soon will be listed here.

Abstract

The burden of patent ductus arteriosus (PDA) continues to be significant. In view of marked differences in preterm infants versus more mature, term counterparts (viewed on a continuum with adolescent and adult patients), mechanisms regulating ductal patency, genetic contributions, clinical consequences, and diagnostic and treatment thresholds are discussed separately, when appropriate. Among both preterm infants and older children and adults, a range of hemodynamic profiles highlighting the markedly variable consequences of the PDA are provided. In most contemporary settings, transcatheter closure is preferable over surgical ligation, but data on longer-term outcomes, particularly among preterm infants, are lacking. The present review provides recommendations to identify gaps in PDA diagnosis, management, and treatment on which subsequent research can be developed. Ultimately, the combination of refined diagnostic thresholds and expanded treatment options provides the best opportunities to address the burden of PDA. Although fundamental gaps remain unanswered, the present review provides pediatric and adult cardiac care providers with a contemporary framework in PDA care to support the practice of evidence-based medicine.

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