At Children's Health℠, our highly experienced pediatric interventional cardiologists use the most advanced tools to perform this minimally invasive procedure. We can even use this technique to treat micro-preemies, who weigh as little as 1.5 pounds. Every year, we perform dozens of these procedures on children of all sizes so they can grow up with hearts that are as strong and healthy as possible.
PDA device closure is used to close an abnormal connection between two arteries leading to the heart, called patent ductus arteriosus.
PDA device closure uses minimally invasive transcatheter techniques. This means doctors only make a small puncture in the vessel in your child’s leg to perform the procedure rather than a larger incision like the ones used for open heart surgeries. Using live X-ray videos to see, they place tiny tubes (catheters) through the puncture, through your child’s blood vessels and into their heart. They then guide a small device through the catheter and into the connection between the arteries to close it. Once it is closed, your child’s heart can work as it should.
Because this procedure uses only a small puncture, it has many advantages over other types of heart surgery. Your child has a lower risk of bleeding, infection and pain. They will also recover more quickly. Some children go home the day of or day after surgery. Premature babies who were in the NICU before their surgery usually return to the NICU to recover.
After your child’s procedure their heart and lungs won’t have to work as hard to pump blood. They will also have an easier time breathing and feeding. You might find their appetite grows quickly and they begin eating a lot more.
Your child will be able to enjoy a normal, active childhood after this procedure. They can play any sport or participate in any activity they would like.
PDA device closure can temporarily increase your child’s risk of infection. Your child will need to take antibiotics before undergoing any other surgeries or dental work for six months after their procedure. After six months, they will no longer need antibiotics.
PDA device closure is considered a safe treatment. However, like any procedure, it has some small risks, including infection, bleeding or injury to your child’s blood vessels. Your doctor will help you understand these risks before your child’s treatment.
Your Children’s Health heart care team will be available to answer any questions you have about your child’s procedure so you understand what to expect.
Your child will need some testing before their surgery to help make sure they don’t have a respiratory infection or other issues that could make surgery unsafe.
In addition, your child’s care team will give you specific instructions on when to stop feeding them the night before their procedure.
Once your child is in the catheterization lab, a pediatric cardiac anesthesiologist will use general anesthesia to put them in a sleep-like state. They will also place a breathing tube to ensure your child gets plenty of oxygen during the procedure.
After your child is asleep, the interventional cardiologist creates a small needle puncture in the femoral blood vessel of your child’s leg. They will take a picture using dye that shows up on X-ray to measure the dimensions of the PDA so they can determine the optimal closure device for your child.
Next, the physician will guide a catheter through the PDA with the help of a wire using the picture previously taken and saved as a roadmap.
They will then place the plug through the catheter and into your child’s PDA, where it will stay for the rest of their lives. When the plug is safely in place, the doctor removes the catheter and bandages the puncture site.
The entire procedure takes about one hour.
After the procedure is over, the anesthesiologist will remove the breathing tube and help your child wake up. If your child was in the NICU before their procedure, they will return to the NICU for more care. You can meet your child there.
If your child was home before their procedure, a nurse will come get you so you can be with your child as they wake up in the post-anesthesia care unit (PACU). In the PACU, we will monitor their breathing, heart rate and blood pressure. We will also perform tests to make sure the device is in a good position and the heart is working properly. Your child might be able to go home in just a few hours or the next day. After returning home, they can eat and play normally.
All children who have a PDA device closure will need a follow-up appointment with their primary cardiologist. Your child may have an echocardiogram at their follow-up appointment to check on how their heart is doing.
We want you to feel comfortable with your child’s care. Please ask your child’s doctor any questions you have, such as:
Yes, the device does show up on X-rays. We will give you a card so you can show airport security proof that you have this device in the event it is necessary.
Yes. We will give you a card you can show any radiologists in the future so they can prepare your child’s MRI in a safe way.
Based on the size and shape of your child’s PDA, your child’s doctor will determine what type of plug is best for their heart. Your child’s device is typically made of a smart metal called nitinol, an alloy of nickel and titanium. Some plugs also have a specialized mesh cloth.
The device will remain in place as your child grows. Their heart will grow around it safely, so it won’t need to be removed in the future..