An Overview on Patent Ductus Arteriosus in Children

Patent ductus arteriosus (PDA) accounts for 5–10% in all congenital heart diseases in term infants,. It is one of the most prevalent congenital heart problems. PDA is more common in preterm newborns and has an inverse relationship with gestational age and weight. The fetus's normal development depends on the preservation of ductal patency. On the other hand, prolonged patency of the ductus arteriosus (DA) in a newborn is linked to a high rate of morbidity and death. Normally, the DA constricts at birth, causing intraluminal ischemia hypoxia, which ultimately causes the ductus to close and remodel. PDA is typically linked to immaturity in preterm infants, although it is typically associated with a functional impairment in mature infants. Prematurity modifies the normal physiological factors that contribute to closure, such as reduced prostaglandins and oxygen tension. Murmurs, tachycardia, bounding peripheral pulses, congestive heart failure, and its accompanying symptoms are clinical indicators of ductal patency. Since symptoms may not usually manifest, diagnostic imaging is essential if a PDA is suspected based on clinical criteria. There are now three approaches to managing PDA: medicinal intervention, surgical ligation, and fluid restriction and diuretics (where clinically appropriate). The administration of intravenous indomethacin or ibuprofen lysine can result in pharmacologic closure. While the efficacy of both medications is comparable, ibuprofen lysine has shown a better safety profile than indomethacin, especially when it comes to renal consequences.