Management of Patent Ductus Arteriosus in the Adult Population

Patent ductus arteriosus (PDA) is defined as a persistent communication between the pulmonary artery and the aorta that normally closes before birth. While the ductus arteriosus is an essential vascular shunt for a developing fetus, its failure to close can become pathologic. Most PDAs are repaired during infancy; however, some remain patent into adulthood, with presentations varying in clinical severity. Untreated PDA can lead to significant morbidity, with complications including left-heart volume overload, arrhythmia, pulmonary hypertension, and possible Eisenmenger syndrome. This review covers the management of PDA in adults, highlighting the pathophysiology, morphological classification, clinical presentation, and current approaches to closure. Transcatheter closure is currently the preferred approach, although surgical methods may be used in patients with distinct anatomy or other concomitant intracardiac pathology. While both methods come with different risk profiles, closure in adults has proven to be effective, resulting in considerable hemodynamic and clinical improvements.