Author: Ms Christa Maria Joel Moderator- Dr. Rashmi Department of Pediatrics Father Muller Medical College 4th Year MBBS

1. PATENT DUCTUS ARTERIOSUS
Christa Maria Joel

2. DEFINITION
• Persistence of a communication between aorta
and pulmonary artery.
• Functional closure: within 12-24 hours after
birth due to contraction of medial smooth
muscle.
• Anatomic closure: between 2-3 weeks
produced by fibrosis of ductal tissue.

3. HEMODYNAMICS

4. Increased
flow after
passing
through
the lungs
reaches
left atrium
Left
atrium
enlarges
in size
Increased
volume
from LA
reaches
the LV in
diastole
across
normal
mitral
valve
Large
volume of
blood in
LV causes
prolongati
on of left
ventricular
systole
and LV
enlarges.
Left
ventricular
volume
ejected
through
normal
aortic
valve into
aorta
causing
dilatation
of
ascending
aorta.

5. CLINICAL FEATURES
• Pulse pressure is wide.
• Prominent arterial Corrigan (carotid) pulsations in the neck may be
present.
• Inspection & palpation: Cardiomegaly, heaving apex, systolodiastolic/
systolic thrill in 2nd LICS, widely transmitted
• Percussion Left border enlarged, 2nd left space dullness
• Auscultation: Continuous machinery murmur in pulmonary area, mid
diastolic murmur in mitral area, by ↑ flow through mitral valves.

6. COMPLICATIONS
• Heart failure
• Infective endocarditis
• Pulmonary arterial hypertension
• Rarely, aneurysmal dilatation of pulmonary
artery and / or ductus, calcification of ductus,
thromboembolism, Eisenmenger syndrome
and rheumatic heart disease.

7. DIAGNOSIS
• Radiology
• Electrocardiography
• Echocardiogram
• Cardiac catheterisation

8. TREATMENT
• Medical closure of PDA- Antiprostaglandin agent
• Surgical intervention- ligation or division
• Catheter based treatment
• Medical management- tackling CCF and prevention and
treatment of infective endocarditis.
• Natural closure takes place in small proportion of cases.
• Asymptomatic PDA- ligation or division of ductus or employing
occlusive devices.

9. THANK YOU