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Patent ductus arteriosus 3(PDA3)

MedGen UID:
934720
•Concept ID:
C4310753
•
Congenital Abnormality
Synonym: PDA3
 
Gene (location): PRDM6 (5q23.2)
 
Monarch Initiative: MONDO:0024266
OMIM®: 617039

Definition

The ductus arteriosus is a vital in utero vascular connection between the aorta and pulmonary artery that allows right ventricular output to bypass the nonventilated fetal lungs. Postnatal closure of the ductus arteriosus is an important step in normal cardiopulmonary transition. Failure of ductal closure results in patent ductus arteriosus (PDA), which occurs in approximately 2 to 8 per 10,000 term infants and constitutes 5% to 7% of all congenital heart defects (summary by Hajj and Dagle, 2012). For a discussion of genetic heterogeneity of isolated PDA, see PDA1 (607411). [from OMIM]

Clinical features

From HPO
Patent ductus arteriosus
MedGen UID:
4415
•Concept ID:
C0013274
•
Congenital Abnormality
In utero, the ductus arteriosus (DA) serves to divert ventricular output away from the lungs and toward the placenta by connecting the main pulmonary artery to the descending aorta. A patent ductus arteriosus (PDA) in the first 3 days of life is a physiologic shunt in healthy term and preterm newborn infants, and normally is substantially closed within about 24 hours after bith and completely closed after about three weeks. Failure of physiologcal closure is referred to a persistent or patent ductus arteriosus (PDA). Depending on the degree of left-to-right shunting, PDA can have clinical consequences.
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Professional guidelines

PubMed

European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update.
Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL
Neonatology 2023;120(1):3-23. Epub 2023 Feb 15 doi: 10.1159/000528914. PMID: 36863329Free PMC Article
Patent ductus arteriosus treatment trends and associated morbidities in neonates.
Park J, Yoon SJ, Han J, Song IG, Lim J, Shin JE, Eun HS, Park KI, Park MS, Lee SM
Sci Rep 2021 May 21;11(1):10689. doi: 10.1038/s41598-021-89868-z. PMID: 34021202Free PMC Article
Understanding the Pathophysiology, Implications, and Treatment Options of Patent Ductus Arteriosus in the Neonatal Population.
Conrad C, Newberry D
Adv Neonatal Care 2019 Jun;19(3):179-187. doi: 10.1097/ANC.0000000000000590. PMID: 30720481

Recent clinical studies

Etiology

Transesophageal echocardiography-guided percutaneous patent ductus arteriosus closure without fluoroscopy.
Wang G, Wu Y, Pan Z, Wu C, Li Y, Li H, Wang Q, Liu B, Dai J
J Cardiothorac Surg 2023 Apr 15;18(1):142. doi: 10.1186/s13019-023-02248-8. PMID: 37060014Free PMC Article
Patent ductus arteriosus, tracheal ventilation, and the risk of bronchopulmonary dysplasia.
Clyman RI, Hills NK, Cambonie G, Debillon T, Ligi I, Gascoin G, Patkai J, Beuchee A, Favrais G, Durrmeyer X, Flamant C, Rozé JC
Pediatr Res 2022 Feb;91(3):652-658. Epub 2021 Mar 31 doi: 10.1038/s41390-021-01475-w. PMID: 33790415Free PMC Article
Patent ductus arteriosus treatment trends and associated morbidities in neonates.
Park J, Yoon SJ, Han J, Song IG, Lim J, Shin JE, Eun HS, Park KI, Park MS, Lee SM
Sci Rep 2021 May 21;11(1):10689. doi: 10.1038/s41598-021-89868-z. PMID: 34021202Free PMC Article
Catheter-based closure of the patent ductus arteriosus in lower weight infants.
Pavlek LR, Slaughter JL, Berman DP, Backes CH
Semin Perinatol 2018 Jun;42(4):262-268. Epub 2018 Jun 13 doi: 10.1053/j.semperi.2018.05.009. PMID: 29909074
Patent arterial duct.
Forsey JT, Elmasry OA, Martin RP
Orphanet J Rare Dis 2009 Jul 10;4:17. doi: 10.1186/1750-1172-4-17. PMID: 19591690Free PMC Article

Diagnosis

The ductus arteriosus: a review of embryology to intervention.
May LA, Masand PM, Qureshi AM, Jadhav SP
Pediatr Radiol 2023 Mar;53(3):509-522. Epub 2022 Oct 12 doi: 10.1007/s00247-022-05518-0. PMID: 36221034
Patent ductus arteriosus treatment trends and associated morbidities in neonates.
Park J, Yoon SJ, Han J, Song IG, Lim J, Shin JE, Eun HS, Park KI, Park MS, Lee SM
Sci Rep 2021 May 21;11(1):10689. doi: 10.1038/s41598-021-89868-z. PMID: 34021202Free PMC Article
Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.
Mitra S, Florez ID, Tamayo ME, Mbuagbaw L, Vanniyasingam T, Veroniki AA, Zea AM, Zhang Y, Sadeghirad B, Thabane L
JAMA 2018 Mar 27;319(12):1221-1238. doi: 10.1001/jama.2018.1896. PMID: 29584842Free PMC Article
Patent arterial duct.
Forsey JT, Elmasry OA, Martin RP
Orphanet J Rare Dis 2009 Jul 10;4:17. doi: 10.1186/1750-1172-4-17. PMID: 19591690Free PMC Article
Patent ductus arteriosus.
Swischuk LE
Semin Roentgenol 1985 Jul;20(3):236-43. doi: 10.1016/0037-198x(85)90007-0. PMID: 2930902

Therapy

Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus.
Hundscheid T, Onland W, Kooi EMW, Vijlbrief DC, de Vries WB, Dijkman KP, van Kaam AH, Villamor E, Kroon AA, Visser R, Mulder-de Tollenaer SM, De Bisschop B, Dijk PH, Avino D, Hocq C, Zecic A, Meeus M, de Baat T, Derriks F, Henriksen TB, Kyng KJ, Donders R, Nuytemans DHGM, Van Overmeire B, Mulder AL, de Boode WP; BeNeDuctus Trial Investigators
N Engl J Med 2023 Mar 16;388(11):980-990. Epub 2022 Dec 6 doi: 10.1056/NEJMoa2207418. PMID: 36477458
Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants.
Jasani B, Mitra S, Shah PS
Cochrane Database Syst Rev 2022 Dec 15;12:CD010061. doi: 10.1002/14651858.CD010061.pub5. PMID: 36519620
Understanding the Pathophysiology, Implications, and Treatment Options of Patent Ductus Arteriosus in the Neonatal Population.
Conrad C, Newberry D
Adv Neonatal Care 2019 Jun;19(3):179-187. doi: 10.1097/ANC.0000000000000590. PMID: 30720481
PDA-TOLERATE Trial: An Exploratory Randomized Controlled Trial of Treatment of Moderate-to-Large Patent Ductus Arteriosus at 1 Week of Age.
Clyman RI, Liebowitz M, Kaempf J, Erdeve O, Bulbul A, Håkansson S, Lindqvist J, Farooqi A, Katheria A, Sauberan J, Singh J, Nelson K, Wickremasinghe A, Dong L, Hassinger DC, Aucott SW, Hayashi M, Heuchan AM, Carey WA, Derrick M, Fernandez E, Sankar M, Leone T, Perez J, Serize A; PDA-TOLERATE (PDA: TO LEave it alone or Respond And Treat Early) Trial Investigators
J Pediatr 2019 Feb;205:41-48.e6. Epub 2018 Oct 16 doi: 10.1016/j.jpeds.2018.09.012. PMID: 30340932Free PMC Article
Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.
Mitra S, Florez ID, Tamayo ME, Mbuagbaw L, Vanniyasingam T, Veroniki AA, Zea AM, Zhang Y, Sadeghirad B, Thabane L
JAMA 2018 Mar 27;319(12):1221-1238. doi: 10.1001/jama.2018.1896. PMID: 29584842Free PMC Article

Prognosis

Intravenous paracetamol in comparison with ibuprofen for the treatment of patent ductus arteriosus in preterm infants: a randomized controlled trial.
Dani C, Lista G, Bianchi S, Mosca F, Schena F, Ramenghi L, Zecca E, Vento G, Poggi C, Leonardi V, Minghetti D, Rosignoli MT, Calisti F, Comandini A, Cattaneo A, Lipone P
Eur J Pediatr 2021 Mar;180(3):807-816. Epub 2020 Sep 4 doi: 10.1007/s00431-020-03780-8. PMID: 32888085Free PMC Article
Patent Ductus Arteriosus-Time for a Definitive Trial.
Mitra S, McNamara PJ
Clin Perinatol 2020 Sep;47(3):617-639. Epub 2020 May 15 doi: 10.1016/j.clp.2020.05.007. PMID: 32713454
Ductus arteriosus and failed medical therapy.
den Harink T, Clur SB, van der Lee R, van Deutekom AW
J Neonatal Perinatal Med 2020;13(1):39-45. doi: 10.3233/NPM-180152. PMID: 32039865
Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with increased nuchal translucency, tricuspid regurgitation and abnormal flow in ductus venosus.
Minnella GP, Crupano FM, Syngelaki A, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2020 May;55(5):637-644. doi: 10.1002/uog.21956. PMID: 31875326
Patent arterial duct.
Forsey JT, Elmasry OA, Martin RP
Orphanet J Rare Dis 2009 Jul 10;4:17. doi: 10.1186/1750-1172-4-17. PMID: 19591690Free PMC Article

Clinical prediction guides

Patent Ductus Arteriosus and Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Bayesian Meta-Analysis.
Villamor E, van Westering-Kroon E, Gonzalez-Luis GE, Bartoš F, Abman SH, Huizing MJ
JAMA Netw Open 2023 Nov 1;6(11):e2345299. doi: 10.1001/jamanetworkopen.2023.45299. PMID: 38015504Free PMC Article
Management and outcomes of periviable neonates born at 22 weeks of gestation: a single-center experience in Japan.
Motojima Y, Nishimura E, Kabe K, Namba F
J Perinatol 2023 Nov;43(11):1385-1391. Epub 2023 Jul 1 doi: 10.1038/s41372-023-01706-4. PMID: 37393397
Defining "Haemodynamic Significance" of the Patent Ductus Arteriosus: Do We Have All the Answers?
Smith A, El-Khuffash AF
Neonatology 2020;117(2):225-232. Epub 2020 May 25 doi: 10.1159/000506988. PMID: 32450558
Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with increased nuchal translucency, tricuspid regurgitation and abnormal flow in ductus venosus.
Minnella GP, Crupano FM, Syngelaki A, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2020 May;55(5):637-644. doi: 10.1002/uog.21956. PMID: 31875326
Understanding the Pathophysiology, Implications, and Treatment Options of Patent Ductus Arteriosus in the Neonatal Population.
Conrad C, Newberry D
Adv Neonatal Care 2019 Jun;19(3):179-187. doi: 10.1097/ANC.0000000000000590. PMID: 30720481

Recent systematic reviews

Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews.
Mitra S, de Boode WP, Weisz DE, Shah PS
Cochrane Database Syst Rev 2023 Apr 11;4(4):CD013588. doi: 10.1002/14651858.CD013588.pub2. PMID: 37039501Free PMC Article
Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants.
Jasani B, Mitra S, Shah PS
Cochrane Database Syst Rev 2022 Dec 15;12:CD010061. doi: 10.1002/14651858.CD010061.pub5. PMID: 36519620
Probiotics to prevent infantile colic.
Ong TG, Gordon M, Banks SS, Thomas MR, Akobeng AK
Cochrane Database Syst Rev 2019 Mar 13;3(3):CD012473. doi: 10.1002/14651858.CD012473.pub2. PMID: 30865287Free PMC Article
Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.
Mitra S, Florez ID, Tamayo ME, Mbuagbaw L, Vanniyasingam T, Veroniki AA, Zea AM, Zhang Y, Sadeghirad B, Thabane L
JAMA 2018 Mar 27;319(12):1221-1238. doi: 10.1001/jama.2018.1896. PMID: 29584842Free PMC Article
Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis.
Fogarty M, Osborn DA, Askie L, Seidler AL, Hunter K, Lui K, Simes J, Tarnow-Mordi W
Am J Obstet Gynecol 2018 Jan;218(1):1-18. Epub 2017 Oct 30 doi: 10.1016/j.ajog.2017.10.231. PMID: 29097178

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