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Updated: Jul 14, 2026
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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
The hemodynamically significant ductus arteriosus in critically ill full-term neonates. Two case reports?
Linh G Ly1, Judith Hawes, Hilary E Whyte
1Division of Neonatology, The Hospital for Sick Children, Toronto, Canada.
Neonatology
|June 15, 2007
Summary
In full-term infants, a large patent ductus arteriosus (PDA) can cause cardiac failure. PDA ligation, not indomethacin, resolved heart failure and improved function in two neonates.
Area of Science:
- Neonatal Cardiology
- Pediatric Cardiac Surgery
Background:
- Hemodynamically significant patent ductus arteriosus (HSDA) is well-documented in premature infants.
- In full-term neonates, the ductus arteriosus (DA) is typically monitored only for specific congenital heart conditions or pulmonary hypertension.
Observation:
- Two full-term infants presented with pulmonary hypertension and myocardial dysfunction.
- Both infants developed cardiac failure secondary to a large, unrestrictive patent ductus arteriosus (PDA).
Findings:
- Medical management with indomethacin provided no clinical benefit in one patient, despite reducing transductal diameter.
- Cardiac failure resolved, and myocardial function improved in both infants following PDA ligation.
Implications:
- Suggests close monitoring of PDA in neonates recovering from persistent pulmonary hypertension of the newborn (PPHN) with persistent oxygenation issues or myocardial failure.
- Highlights PDA ligation as a viable therapeutic option for full-term neonates with cardiac failure due to HSDA when other treatments fail.
