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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

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
Trends in Patent Ductus Arteriosus Diagnosis and Management for Very Low Birth Weight Infants.
Ngo S, Profit J, Gould JB, Lee HC
Pediatrics 2017 Apr;139(4) doi: 10.1542/peds.2016-2390. PMID: 28562302Free PMC Article
Association of Patent Ductus Arteriosus Ligation With Death or Neurodevelopmental Impairment Among Extremely Preterm Infants.
Weisz DE, Mirea L, Rosenberg E, Jang M, Ly L, Church PT, Kelly E, Kim SJ, Jain A, McNamara PJ, Shah PS
JAMA Pediatr 2017 May 1;171(5):443-449. doi: 10.1001/jamapediatrics.2016.5143. PMID: 28264088Free PMC Article
Morbidity and mortality in preterm neonates with patent ductus arteriosus on day 3.
Sellmer A, Bjerre JV, Schmidt MR, McNamara PJ, Hjortdal VE, Høst B, Bech BH, Henriksen TB
Arch Dis Child Fetal Neonatal Ed 2013 Nov;98(6):F505-10. Epub 2013 Jul 26 doi: 10.1136/archdischild-2013-303816. PMID: 23893268
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

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
Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus.
Guler Kazanci E, Buyuktiryaki M, Unsal H, Tayman C
Am J Perinatol 2019 Dec;36(14):1521-1527. Epub 2019 May 14 doi: 10.1055/s-0039-1688821. PMID: 31087312
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 Ductus Arteriosus in Extreme Prematurity: Role of Echocar-diography and Other Imaging Techniques.
Yap N, Bharucha T
Curr Pediatr Rev 2016;12(2):126-35. doi: 10.2174/157339631202160506002656. PMID: 27197955
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

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
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
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
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

Indomethacin for symptomatic patent ductus arteriosus in preterm infants.
Evans P, O'Reilly D, Flyer JN, Soll R, Mitra S
Cochrane Database Syst Rev 2021 Jan 15;1(1):CD013133. doi: 10.1002/14651858.CD013133.pub2. PMID: 33448032Free PMC Article
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
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
Association of Patent Ductus Arteriosus Ligation With Death or Neurodevelopmental Impairment Among Extremely Preterm Infants.
Weisz DE, Mirea L, Rosenberg E, Jang M, Ly L, Church PT, Kelly E, Kim SJ, Jain A, McNamara PJ, Shah PS
JAMA Pediatr 2017 May 1;171(5):443-449. doi: 10.1001/jamapediatrics.2016.5143. PMID: 28264088Free 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

Clinical prediction guides

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
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
Prostaglandin E1 for maintaining ductal patency in neonates with ductal-dependent cardiac lesions.
Akkinapally S, Hundalani SG, Kulkarni M, Fernandes CJ, Cabrera AG, Shivanna B, Pammi M
Cochrane Database Syst Rev 2018 Feb 27;2(2):CD011417. doi: 10.1002/14651858.CD011417.pub2. PMID: 29486048Free PMC Article
Physiological marker and surgical ligation of patent ductus arteriosus in neonates.
Banieghbal B
Afr J Paediatr Surg 2016 Jul-Sep;13(3):109-13. doi: 10.4103/0189-6725.187796. PMID: 27502877

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
Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants.
Ohlsson A, Walia R, Shah SS
Cochrane Database Syst Rev 2020 Feb 11;2(2):CD003481. doi: 10.1002/14651858.CD003481.pub8. PMID: 32045960Free PMC Article
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

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