Patent Ductus Arteriosus (PDA)

Patent Ductus Arteriosus (PDA) - Preparing for Procedure

During the test

This procedure is performed under local anaesthetic (LA) in the cardiac catheterisation lab. A plastic catheter (a long tube) will be inserted via a vein in the groin and navigated until it reaches the heart. Depending on the case, the catheter may be positioned at different chambers of your heart to measure the pressure and oxygen content prior to device closure. In certain circumstances, balloon sizing of the PDA may be required. Once your doctor is satisfied with all the measurements, the appropriate size device is connected onto a cable, put into a special delivery tube, advanced through your PDA and carefully deployed. Your doctor will study the device’s position and stability before releasing the device. The catheter will be removed and the procedure is completed.

The procedure usually takes between 1 and 2 hours and the success rate is about 95%.

Risks

However, there are known risks involved. The risks and their estimated incidence of occurrence are:

• Device dislodgement (embolisation) and the need for emergency heart surgery: <1%
• Death: <1% (usually from perforation of the heart chamber).
• Dislodgement of clot or air bubbles to the brain (causing stroke) and other organs: <1% 
• Rhythm disturbance (arrhythmia) (usually transient): <1%
• Device distorting blood flow in the pulmonary artery: <1%
• Other potential risks: Allergic dye reaction, anaesthetic reaction, bleeding and bruising around the sheaths in the groin, injury to the artery/vein/nerves in the groin, infection, fever, headache, migraine, allergic reaction to the nickel component of the device 

Some of these complications if they occur, are of a serious nature and may require further treatment including surgery and prolonged hospitalisation. In the event of device dislodgement, you may require surgery for removal of the device and ligation of the PDA at the same time.

This procedure is suitable for adults with PDA and heart enlargement or elevated pressure in the lung (as long as pressure is not irreversibly elevated). In adults, a device rather than coils is used as the defect is usually > 4mm in size. If the lung pressure is already very high, careful measurement of the lung pressure and lung resistance need to be performed first to determine if it is still safe to close such a defect.