Comparative case studies: PDAs treated with medication, surgical ligation, and transcatheter device closure

The ductus arteriosus is a lifeline for the developing fetus prior to delivery, allowing the circulation of oxygen-rich blood from the placenta to bypass the lungs and perfuse the body. However, when the ductus fails to close after birth, the pressures can cause blood to shunt from the aorta back into the lungs, causing pulmonary edema. This is called a left-to-right shunt. The patent ductus arteriosus (PDA) can also shunt blood from the pulmonary arteries to the aorta, bypassing the lungs and causing oxygen-poor blood to mix with the oxygen-rich blood circulating to the body. This is called a right-to-left shunt. Too much shunting in either direction can cause significant long-term problems for the neonate. These three case studies compare the outcomes of patients with PDAs closed using different treatment techniques. The first patient's ductus arteriosus closed >2 months after birth following pharmacologic treatment. The second was closed by surgical ligation. The third was closed by transcatheter device closure.