8th March 2024

Management

This depends on the age of the patient, whether they are an infant, child or adult and the size and degree of left-to-right shunting. In preterm infants, pharmacological therapy using cyclo-oxygenase inhibitors such as Indomethacin is used. For adults, treatment is with transcatheter device closure rather than surgical closure, which is reserved for very large PDA, aneurysms or endarteritis.

Indications for PDA closure include small, moderate and large PDAs without Eisenmenger’s physiology and all patients with LV failure and no pulmonary hypertension, regardless of symptoms.  Closure is not recommended in severe pulmonary hypertension and Eisenmenger’s physiology with right-to-left shunt due to the risk of life threatening pulmonary oedema.