Pulmonary Hypertension with Prolonged Patency of the Ductus Arteriosus in Preterm Infants

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Ranjit Philip1, Vineet Lamba1, Ajay Talati1

  • 1LeBonheur Children's Hospital, University of Tennessee, 51 North Dunlap St., Memphis, TN 38104, USA.

Children (Basel, Switzerland)
|September 19, 2020
PubMed

Insights

Closing a patent ductus arteriosus (PDA) in premature infants is debated. This review covers pulmonary vasculature changes and cardiac catheterization for hemodynamically significant PDA in preterm infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Medical Imaging

Background:

  • Patent ductus arteriosus (PDA) is common in premature infants, with ongoing debate regarding long-term benefits of closure.
  • Hemodynamically significant PDAs can lead to chronic changes in pulmonary vasculature.
  • Understanding these changes is crucial for appropriate clinical management.

Purpose of the Study:

  • To review pulmonary vasculature alterations in preterm infants with chronic, hemodynamically significant PDA.
  • To explain the rationale and decision-making process for diagnostic cardiac catheterization.
  • To detail the approach to transcatheter PDA closure in this population.

Main Methods:

  • Review of existing literature on PDA in preterm infants.
  • Analysis of pulmonary vasculature changes associated with chronic PDA.
  • Discussion of diagnostic cardiac catheterization procedures.
  • Overview of transcatheter PDA closure techniques.

Main Results:

  • Chronic PDA can induce significant and potentially irreversible pulmonary vascular remodeling.
  • Cardiac catheterization provides essential hemodynamic and anatomical data for treatment decisions.
  • Transcatheter closure is a viable option for managing PDA in select preterm infants.

Conclusions:

  • Pulmonary vasculature changes in preterm infants with PDA necessitate careful evaluation.
  • Cardiac catheterization plays a key role in guiding management strategies.
  • Transcatheter closure offers a minimally invasive approach for PDA treatment in preterm infants.

Keywords:
congestive heart failureneonatologypatent ductus arteriosuspediatricspreterm infantpulmonary hypertensionpulmonary vascular resistancesurgical ligation of PDAtrans-catheter PDA closure

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