What will happen if patent ductus arteriosus is not treated with surgery?

Written by Xie Zhi Hong
Cardiology
Updated on December 24, 2024
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Patients with patent ductus arteriosus are characterized by a congenital connection between the pulmonary artery and the aortic arch. This is a remnant passageway that was used during embryonic development to supply blood within the umbilical vessels, ensuring the development of the infant. Normally, this ductus arteriosus may close on its own within a few months. If it does not close after one year from birth, it is considered a patent ductus arteriosus. This condition can lead to increased workload on the heart. Because it allows blood pumped into the aorta to return to the right ventricle, over time, this can increase the burden on the left ventricle as well as the right ventricle. This may lead to heart failure and, in severe cases, trigger Eisenmenger's syndrome. If this condition reaches such a state, the patient loses the opportunity for surgery, resulting in a shortened lifespan.

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Written by Fan Yan Fu
Cardiology
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Does patent ductus arteriosus require open chest surgery?

Now, many cases of patent ductus arteriosus do not require open-chest surgery, as they can be treated minimally invasively by cardiologists through what is called interventional treatment. The ductus arteriosus is actually a vessel between the aorta and the pulmonary artery during the embryonic stage, which usually closes shortly after birth. If it does not close, it results in a congenital heart disease. In the past, before the widespread use of interventional treatments, open-chest surgery was required to ligate the vessel. With the broad implementation of interventional treatments, cardiologists can now treat this condition minimally invasively. This is mainly done by delivering a spring coil through a catheter to the ductus arteriosus which then blocks the vessel, allowing it to gradually close and thus achieve the therapeutic goal. Alternatively, a gelatin sponge can be delivered to the ductus arteriosus through a catheter to block and eventually close the vessel, achieving the desired treatment outcome.

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Written by Tang Li
Cardiology
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Why does patent ductus arteriosus cause a decrease in diastolic pressure?

In patients with patent ductus arteriosus, since the aortic pressure is significantly higher than the pulmonary artery pressure throughout the cardiac cycle, there is continuous blood flow from the aorta into the pulmonary artery through the open duct, causing a left-to-right shunt. This increases the blood volume in the pulmonary circulation, causing dilatation of the pulmonary artery and its branches. The blood flow returning to the left heart system also increases, thereby increasing the load on the left heart and causing the left heart to enlarge. Due to the diastolic diversion of blood from the aorta to the pulmonary artery, the peripheral arterial diastolic pressure decreases and the pulse pressure increases.

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Written by Xie Zhi Hong
Cardiology
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Is a patent ductus arteriosus funnel type severe?

The arterial duct is a pathway through which blood from the maternal placenta is delivered to the fetus. This pathway usually closes at birth, and in most cases, it successfully closes within three months. If it remains open after one year, it can be diagnosed as a patent ductus arteriosus. The shapes of the arterial duct include funnel-shaped, tubular, and window-type. Regardless of the type, if it does not cause serious cardiac complications, it can be addressed with interventional treatments or surgical procedures, making it a relatively non-severe condition. However, if the patent ductus arteriosus remains open for a long time, leading to severe pulmonary arterial hypertension and even left-to-right shunts causing serious cardiac dysfunction, it is considered severe. Therefore, the shape of the patent ductus arteriosus does not have diagnostic significance regarding the severity of the condition. Rather, the severity is assessed based on the patient's symptoms, evaluation of cardiac function through echocardiography, and the condition of pulmonary artery pressure. In the early stages, most cases of patent ductus arteriosus are not very serious and can be resolved through treatment.

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Written by Di Zhi Yong
Cardiology
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Which is more serious, patent ductus arteriosus or ventricular septal defect?

Both of these diseases are types of congenital heart disease, and if there are issues with either of them, the situation can be quite severe. There isn't a distinction between which disease is severe and which is not. If the arterial duct remains open or does not close, surgery is still required for this condition. Patients with ventricular septal defect primarily display changes related to ischemia and hypoxia, and they may also experience recurrent respiratory infections, which are quite serious. Surgery is generally the best treatment. Early surgical intervention can achieve a complete cure, but it is also advisable for the patient to have regular echocardiographic check-ups at the hospital.

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Written by Di Zhi Yong
Cardiology
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Will patent ductus arteriosus increase with age?

Patent ductus arteriosus is a type of congenital heart disease, primarily treated through surgery. Early surgical intervention can completely cure this disease. However, as age increases, the symptoms of this disease can become more severe. Based on the patient's condition, it is recommended to undergo early surgical treatment at a hospital to alleviate the patient's suffering. As age increases, various organic diseases may emerge, which can sometimes affect a child's growth and development. During this period, it is advised that the patient regularly revisits the hospital for echocardiography checks and to also be cautious in preventing upper respiratory infections.