What is a PDA, and what does closure involve?
Before birth, a baby does not use their lungs, so a small vessel called the ductus arteriosus diverts blood past them. It is supposed to close within a few days of birth. When it does not, it is called a patent ductus arteriosus, and blood keeps flowing from the aorta into the lung arteries when it should not.
A significant PDA can flood the lungs, strain the heart, and stop a baby from feeding and growing properly. In premature babies it can be a serious problem.
Device closure plugs the vessel from inside. A small implant is delivered through a catheter from the groin and positioned within the duct, sealing it.
When closure is recommended
Closure in premature and very small babies
This is an area of particular expertise for Dr. Pankaj Sugaonkar, who has performed PDA device closure in premature infants of very low birth weight, including babies under a kilogram. In such small babies, avoiding surgical ligation and the chest incision that comes with it is a substantial advantage.
What happens on the day
Under general anaesthesia or deep sedation, a catheter is passed from the groin to the duct. An angiogram defines its exact shape and size — ducts vary considerably. The appropriately sized device is deployed and its position confirmed before release.
The procedure is usually quick, often under an hour, and one of the more straightforward transcatheter closures.
Recovery
Most children go home the following day. Older children resume normal activity within a week. Premature babies remain under neonatal care as their overall condition requires.