Patent Ductus Arteriosus (PDA) Closure Program

Patent ductus arteriosus, also known as PDA, is a congenital heart defect (CHD) that occurs when the ductus arteriosus, a blood vessel that is normally present in all babies when they are in the womb, does not close after birth.

Ductus Arteriosus Function

The fetal ductus arteriosus connects an unborn baby’s aorta and pulmonary arteries, the two large blood vessels that leave the heart, and helps direct oxygenated blood away from the lungs (which the baby does not need before birth) and to the rest of the body.

Before birth, the baby gets oxygen through the placenta, not the lungs. Once the baby is born, the lungs begin working to provide oxygen to the blood, and the ductus arteriosus naturally shrinks and closes. Patent ductus arteriosus occurs when the ductus arteriosus does not close on its own, and can result in severe complications that affect the heart and lungs.

Patent ductus arteriosus symptoms can include:

• Difficulty breathing that leads to need for respiratory support.
• Abnormally high blood pressure in the lung arteries.
• Cardiac enlargement with symptoms of congestive heart failure.
• Poor growth.
• Feeding intolerance that may lead to gut injury.
• Diversion of blood away from critical organs.
• Heart murmur.

Patent Ductus Arteriosus in Full-Term vs. Preemie Babies

In full-term babies, patent ductus arteriosus is not always a serious issue and usually closes on its own in the first few days of life. The ductus arteriosus is less likely to close on its own in premature babies, and has been associated with serious complications including heart failure, lung damage, and necrotizing enterocolitis, a condition that causes severe gut damage and other life-threatening conditions.

The PDA Closure Program at the Children’s Heart Center is dedicated to providing the best care possible for premature babies with patent ductus arteriosus. Our PDA Closure Program brings together a multidisciplinary team of pediatric cardiologists, interventional cardiologists, neonatologists, anesthesiologists, respiratory therapists, NICU nurses and catheterization lab support staff who specialize in the diagnosis and treatment of patent ductus arteriosus in infants and premature babies. One of the few cardiac programs in Georgia that treats patent ductus arteriosus in infants using a less-invasive, catheter-based therapy, we use innovative treatments to deliver the best possible outcomes, including the first FDA-approved implantable PDA closure device for preterm infants. From the moment of referral through the procedure and recovery, our neonatology and pediatric cardiology teams work in close partnership. Continuous communication and coordinated planning at every stage ensure alignment in your baby’s care.

Why Choose the Children’s PDA Closure Program?

• Nationally Ranked Care: You can feel reassured that your baby is receiving high-quality care from Georgia’s only nationally ranked hospital in pediatric cardiology and heart surgery, as well as neonatology.
• Leaders in PDA Closure: The PDA Closure Program at the Children’s Heart Center was the first program in Georgia to offer minimally invasive transcatheter PDA closure. We are one of just a few hospitals in the country that can perform PDA closures in premature infants smaller than 1kg through cardiac catheterization.
• Excellent Outcomes: Our catheterization lab has some of the highest volumes in the country, which means your child is receiving care from an experienced team of heart specialists. Our team’s expertise, combined with advanced, minimally invasive treatment helps provide your baby with the best possible outcome.
• Research and Innovation: Our PDA Closure program is active in clinical research and participates in trials that help drive innovative technology. We help the community learn who is a good candidate for this procedure and when patients can benefit most.

Transport Services to the PDA Closure Program

The Children's Heart Center works with NICUs throughout Georgia to provide expedited care for premature infants with patent ductus arteriosus by transferring patients from the NICU of the birthing hospital to the NICU at Children's prior to their procedure in the catheterization lab at the Children's Heart Center. Our transport services include a fleet of emergency vehicles that are specially equipped and staffed by critical care professionals to stabilize patients on the way to our hospital. Our dedicated team works to expedite referrals, deliver treatment and safely transfer the baby back to the referring NICU.

Transfer a Patient to Children’s (Physicians Only)

Physicians can transfer a patient to the Children's PDA Closure Program by emailing us at neonatalpdareferrals@choa.org. This will help ensure a smooth and convenient experience.

Reach the Children's Transfer Center:

Phone: 404-785-7778 or 888-785-7778
Fax: 404-785-7779

Transfers and Referrals

Your child’s healthcare provider may suspect patent ductus arteriosus when they listen to your baby’s heart with a stethoscope. They may hear a distinct PDA murmur, or an abnormal sound of blood flowing through the heart or blood vessels and may recognize other signs such as worsening respiratory function or low blood pressure.

How is patent ductus arteriosus diagnosed?

Your baby’s pediatric cardiologist may use a variety of imaging tests to confirm a patent ductus arteriosus diagnosis, including:

• Chest X-Ray: A chest x-ray uses a small dose of radiation to create images of the heart, lungs, blood vessels and bones of the chest.
• Echocardiogram: An echocardiogram is a test that uses ultrasound waves to create accurate pictures of your baby’s heart to look at its structure and see how it is functioning. This can demonstrate the patent ductus arteriosus effects on the heart and lungs, as well as determine candidacy for device closure.

If a patent ductus arteriosus diagnosis is confirmed, your child will be referred to a pediatric cardiologist at the Children's Heart Center for treatment.

How is patent ductus arteriosus treated?

Our team of pediatric cardiologists and neonatologists are at the forefront of advanced treatments for patent ductus arteriosus. Our cardiology team specializes in transcatheter PDA closures and have performed more than 350 since 2021, making us one of the highest volume programs in North America.

Each treatment is unique based on how big the opening is, whether the baby is full-term or premature and if there are any other symptoms or complications. Treatments may include:

• Monitoring: Some PDAs close on their own as they grow, even in preterm infants. Your child may be monitored using diagnostic tests including chest x-ray and echocardiography as a part of clinical management.
• Medications: Some medications are available to help the ductus arteriosus close. Your child's neonatologist, pediatric cardiologist or both will carefully discuss side effects and if your child is a good candidate.
• Transcatheter PDA Closure: A minimally invasive procedure in which a long, thin tube called a catheter is guided to the ductus arteriosus through a vein in your baby’s leg. The doctor will then carefully place a device in the ductus arteriosus that will create a controlled clot and effectively close the blood vessel. As your baby grows, their tissue will grow over the PDA closure device, which makes it become a part of their body so it will never need to be removed or changed. Transcatheter PDA closure may result in shorter hospital stays, faster discharge and potentially better lung function than traditional open surgery.

Long-term care after PDA closure

Infants treated in our PDA Closure Program are often able to transfer back soon after their procedure to the referring NICU to continue progressing towards home. Most patients will need to see a pediatric cardiologist each year to monitor their heart health.

• Allen Ligon, MD, Program Co-Director
• Shazia Bhombal, MD, Program Co-Director
• Sarah Hash, RN, Program Manager

Cardiologists

• Holly Bauser-Heaton, MD, PhD
• Dennis Kim, MD
• James Kuo, MD

Neonatologists

• Shannon Hamrick, MD
• Anthony Piazza, MD