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Treatments and drugs
By Mayo Clinic staffIn a premature infant, the patent ductus arteriosus often closes on its own in the weeks after birth. In a full-term infant, a patent ductus arteriosus usually will close within the first few days of life. If the defect doesn't close and is causing health problems, medications or surgery may be used to close it.
Medications
Doctors use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or indomethacin, to help close a patent ductus arteriosus in premature infants. NSAIDs block the hormone-like chemicals in the body that keep the PDA open.
Surgery
Surgery to repair a patent ductus arteriosus involves patching or sewing shut the abnormal opening. This can be done through an incision in the side of the chest or by catheterization. In cardiac catheterization, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil may be deployed to close the ductus arteriosus. In surgery, the ductus is closed with a metal clip.
Preventive antibiotics
In the past, it was recommended that people with an unrepaired patent ductus arteriosus take antibiotics before dental work and certain types of surgical procedures to prevent infective endocarditis.
But new guidelines issued by the American Heart Association in 2007 have substantially revised this recommendation. After weighing the risks and benefits of preventive antibiotics, the reviewing committee found that the risks outweighed the benefits for most people, except a small group at high risk of serious complications of infectious endocarditis.
The reviewers found that random germs caused infectious endocarditis more frequently than did routine dental or medical procedures. They suggest a more effective strategy for preventing endocarditis may be to practice good oral hygiene and get regular dental checkups. They also noted that taking preventive antibiotics carries certain uncommon though possible risks, such as an allergic reaction, and may contribute to growing antibiotic resistance.
Because of these changes, preventive antibiotics are no longer recommended for many people with a patent ductus arteriosus. However, some people still need antibiotics, such as those who:
- Have other heart conditions or artificial valves
- Have a large defect that's causing a low blood oxygen level
- Have had repair with prosthetic material
If you've been told you or your child needed to take antibiotics before any procedures in the past, talk with your doctor about how these new recommendations apply to you.
