Pediatric patent ductus arteriosus (PDA) stent

What is a pediatric patent ductus arteriosus (PDA) stent?

The patent ductus arteriosus (PDA) is a blood vessel that every baby has before birth. It’s required for fetal circulation. This blood vessel allows blood to flow from the heart through the body while the baby is in the womb. After birth, the blood vessel closes within the first week of life. Babies with a healthy heart don’t need the PDA blood vessel after birth because they have a normal pulmonary valve in the heart that allows their blood to flow properly to the lungs.

Babies born with a severe abnormality of their pulmonary valve often get a PDA stent. They need urgent treatment after birth to ensure blood can continue to flow into the lungs.

In this procedure, doctors insert a stent (small metal mesh tube) into the PDA blood vessel to keep it open. Rather than opening the chest, doctors reach the heart through a small incision in the leg, neck or arm. Doctors guide a thin tube (catheter) into the PDA and into the lung blood vessel. A thin guide wire, which acts like a rail, is inserted to guide the balloon catheter with the stent through this small incision until they reach the PDA blood vessel in the heart. Then, they insert the stent.

This procedure is typically performed when a baby is 5 to 7 days old.

What are the benefits of a pediatric patent ductus arteriosus (PDA) stent?

A PDA stent is a minimally invasive procedure. This means babies may typically recover and go home faster than with open-heart surgery. Because doctors make a small incision, there isn’t scar tissue in the chest that could cause complications for the baby’s next procedure.

What are the side effects of PGE1?

In the days before the baby’s PDA stent procedure, doctors will give them medicine, called PGE1, to keep the PDA open and blood flowing into the lungs. This medicine is lifesaving, but it can have some side effects. These side effects can include fever, low blood pressure, poor feeding or apnea, which means the baby temporarily stops breathing. If that happens, they’ll receive assistance to help them breathe. These babies receive round-the-clock care from our team.

What are the risks of a pediatric patent ductus arteriosus (PDA) stent?

Before the procedure, a team of doctors performs extensive tests to determine if a PDA stent is the best treatment. Because these heart conditions are so complex, doctors may find that they need to perform open heart surgery instead to do the procedure successfully. Doctors are prepared to change their approach during the procedure if necessary.

During the PDA stent procedure, doctors reach the heart through a blood vessel in the leg, neck or arm. There’s a risk of a complication with one of these blood vessels, like bleeding or poor blood flow. Typically, this complication is minor.

After the procedure, there’s a risk of the tissue that lines the blood vessel growing inside the stent, causing it to narrow. This is called in-stent stenosis. We’re constantly evaluating your baby and will provide treatment if that happens.

What to expect with a pediatric patent ductus arteriosus (PDA) stent procedure

Our team of heart and intensive care specialists work together before, during and after the procedure to help babies have the best outcomes.

What to expect before a pediatric patent ductus arteriosus (PDA) stent procedure

Most parents find out their baby has a severe heart condition while the baby is still in the womb. After your baby is born, doctors will give them medication and begin evaluating them to determine the best treatment plan.

Our team will perform tests, including an echocardiogram and CT scan, to gather information about the structure and function of your baby’s heart. Several cardiologists, cardiac surgeons, anesthesiologists and other heart and intensive care specialists review the test results. Together, they decide if the PDA stent is the best approach for your baby. Then, they will discuss the treatment options with parents before scheduling the procedure for when your baby is 5-7 days old.

What to expect during a pediatric patent ductus arteriosus (PDA) stent procedure

The procedure typically takes about an hour and a half. Doctors will place the baby under general anesthesia, then they’ll perform the procedure to place the stent in the PDA vessel.

What to expect after a pediatric patent ductus arteriosus (PDA) stent procedure

• Cardiac Intensive Care Unit (CICU) - After the procedure, we’ll take your baby to the cardiac intensive care unit (CICU) for recovery and round-the-clock care. You will be able to visit your baby there. Babies usually spend one to two weeks in the hospital before going home with parents through our Safe at Home Program.

• Safe at Home Program - The Safe at Home Program educates and empowers parents to help care for their infant with a severe heart condition. You’ll receive special equipment and instructions to care for your baby, and our expert team is available 24/7 through video call or by phone. If your baby needs emergency care, we’re available at all times to treat them in our emergency department.

• Follow-up care - The PDA stent is usually in place for three to four months. During that time, your baby will have weekly appointments so the cardiologist can make sure the stent is working properly. In those weekly visits, the team will also begin planning the next procedure to treat your baby’s heart condition.

What questions should I ask my provider about a pediatric patent ductus arteriosus (PDA) stent procedure?

• How many PDA stents have you performed?

• Are there other treatment options for my baby?

• How soon will I be able to see my baby after the PDA stent procedure?

• What special equipment will I have to care for my baby at home?