Patent ductus arteriosus indications for surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Contraindication

• Severe and irreversible pulmonary artery hypertension
• Eisenmenger's syndrome.

There is some lack on consensus on the management strategies of silent and small patent ductus arteriosus.

Small PDA

Small PDA may present with audible murmur with or without symptoms of left volume overload. The American College of Cardiology/American Heart Association (ACC/AHA)recommends closure of small PDA, even without evident left sided volume overload. In case the PDA is left untreated, a follow-up every 3-5 year is recommended.

Silent PDA

Silent PDA

• No audible murmur.
• Detected incidentally on diagnostic procedures done for other conditions.
• Some experts are of opinion that silent PDA should be closed to decrease the risk of future endocarditis. Others believe that since silent PDA have very less risk for causing any hemodynamic complications in future so it could be left without any surgical intervention.