Patent ductus arteriosus medical therapy

Associate Editor-In-Chief:; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu] Priyamvada Singh, MBBS mailto:psingh@perfuse.org

Assistant Editor-In-Chief: Kristin Feeney, B.S. mailto:kfeeney@perfuse.org

Medical Therapy
Infants without adverse symptoms may simply be monitored as outpatients, while symptomatic PDA can be treated with both surgical and non-surgical methods. Medical therapy involves being treated with indomethacin (0,2mg/Kg IV) to close the PDA. Indomethacin therapy has known limitations in severe cases of PDA. Patients with cases involving the transposition of the great vessels (TGV) may need the ductus arteriosus kept open with prostaglandin E1 (PGE1). Often, these pateints require surgical intervention instead.

Fluid restriction and prostaglandin inhibitors such as indomethacin have also been used in successful non-surgical closure of the DA. This is an especially viable alternative for premature infants. If indomethacin fails or if a child is more than 6 to 8 months old, surgical ligation of the PDA can be accomplished with excellents results in uncomplicated patients. Recent experience with transcatheter closure has also been favorable, being today the procedure of choice for most patients.