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

Journal Article (Journal Article;Review)

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.

Full Text

Duke Authors

Cited Authors

  • Backes, CH; Hill, KD; Shelton, EL; Slaughter, JL; Lewis, TR; Weisz, DE; Mah, ML; Bhombal, S; Smith, CV; McNamara, PJ; Benitz, WE; Garg, V

Published Date

  • September 6, 2022

Published In

Volume / Issue

  • 11 / 17

Start / End Page

  • e025784 -

PubMed ID

  • 36056734

Pubmed Central ID

  • PMC9496432

Electronic International Standard Serial Number (EISSN)

  • 2047-9980

Digital Object Identifier (DOI)

  • 10.1161/JAHA.122.025784

Language

  • eng

Conference Location

  • England