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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

Targeted neonatal echocardiography service in neonatal intensive care in Manitoba, Canada.
Alammary D, Narvey M, Soni R, Elsayed Y, Louis D
J Perinatol 2022 May;42(5):655-659. Epub 2021 Oct 29 doi: 10.1038/s41372-021-01258-5. PMID: 34716384
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
Staged Hybrid Approach for Ductal Origin of the Pulmonary Artery in a Low Birth Weight Neonate.
Prabhu S, Maiya S, Shetty R, Murthy K, Ramachandra P
World J Pediatr Congenit Heart Surg 2021 May;12(3):429-432. Epub 2019 May 22 doi: 10.1177/2150135118822302. PMID: 31117873
Survey of PDA management in very low birth weight infants across Italy.
Ficial B, Corsini I, Fiocchi S, Schena F, Capolupo I, Cerbo RM, Condò M, Doni D, La Placa S, Porzio S, Rossi K, Salvadori S, Savoia M; On the behalf of the Italian Study Group of Neonatal Cardiology of the Italian Society of Neonatology
Ital J Pediatr 2020 Feb 14;46(1):22. doi: 10.1186/s13052-020-0773-0. PMID: 32059689Free PMC Article
Transcatheter closure of persistent ductus arteriosus in adults.
Bentham JR, Thomson JD, Gibbs JL
J Interv Cardiol 2012 Oct;25(5):501-4. Epub 2012 Jun 7 doi: 10.1111/j.1540-8183.2012.00749.x. PMID: 22672406

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
Hypertrophic cardiomyopathy in an extremely preterm infant.
Aiyengar A, Howarth C, Pereira S
BMJ Case Rep 2021 Mar 9;14(3) doi: 10.1136/bcr-2020-239787. PMID: 33687939Free PMC Article
A Doppler ghost in the pulmonary artery.
Cagli K, Ozbulbul NI, Ozeke O, Calapkulu MY, Golbasi Z
Echocardiography 2020 Mar;37(3):472-473. Epub 2020 Feb 24 doi: 10.1111/echo.14621. PMID: 32092170
Ductal arterial spasm: a nightmare.
Phyu HL, Oo KM
Cardiol Young 2020 Mar;30(3):422-423. Epub 2020 Jan 27 doi: 10.1017/S1047951119003238. PMID: 31983349
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

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
Ductal arterial spasm: a nightmare.
Phyu HL, Oo KM
Cardiol Young 2020 Mar;30(3):422-423. Epub 2020 Jan 27 doi: 10.1017/S1047951119003238. PMID: 31983349
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
Closing the patent duct: context and controversy.
Bu'Lock F
Arch Dis Child Fetal Neonatal Ed 2018 May;103(3):F194-F195. Epub 2017 Nov 1 doi: 10.1136/archdischild-2017-313593. PMID: 29092911

Prognosis

Targeted neonatal echocardiography service in neonatal intensive care in Manitoba, Canada.
Alammary D, Narvey M, Soni R, Elsayed Y, Louis D
J Perinatol 2022 May;42(5):655-659. Epub 2021 Oct 29 doi: 10.1038/s41372-021-01258-5. PMID: 34716384
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
Survey of PDA management in very low birth weight infants across Italy.
Ficial B, Corsini I, Fiocchi S, Schena F, Capolupo I, Cerbo RM, Condò M, Doni D, La Placa S, Porzio S, Rossi K, Salvadori S, Savoia M; On the behalf of the Italian Study Group of Neonatal Cardiology of the Italian Society of Neonatology
Ital J Pediatr 2020 Feb 14;46(1):22. doi: 10.1186/s13052-020-0773-0. PMID: 32059689Free PMC Article
Ductal arterial spasm: a nightmare.
Phyu HL, Oo KM
Cardiol Young 2020 Mar;30(3):422-423. Epub 2020 Jan 27 doi: 10.1017/S1047951119003238. PMID: 31983349
Neonatal hypertension. Incidence and risk factors.
Singh HP, Hurley RM, Myers TF
Am J Hypertens 1992 Feb;5(2):51-5. doi: 10.1093/ajh/5.2.51. PMID: 1550665

Clinical prediction guides

Analysis of perinatal risk factors for massive pulmonary hemorrhage in very low birth weight infant: A nationwide large cohort database.
Jung JK, Kim EY, Heo JS, Park KH, Choi BM
Early Hum Dev 2024 Apr;191:105977. Epub 2024 Mar 5 doi: 10.1016/j.earlhumdev.2024.105977. PMID: 38460343
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
Perinatal events predicting retinopathy of prematurity in extremely pre-term infants.
AlRyalat SA, Al Oweidat K, Al-Amer A, Khader A, Ajaj A, Alessa Z, Roto A
J Neonatal Perinatal Med 2020;13(2):261-266. doi: 10.3233/NPM-190336. PMID: 32250325
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
Hepatogonadal fusion.
Fan R, Faught PR, Sun J, Meldrum KK
J Pediatr Surg 2012 Feb;47(2):e5-6. doi: 10.1016/j.jpedsurg.2011.10.071. PMID: 22325418

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
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
The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports.
Stambolliu E, Ioakeim-Ioannidou M, Kontokostas K, Dakoutrou M, Kousoulis AA
J Child Neurol 2017 Sep;32(10):886-902. Epub 2017 Jun 21 doi: 10.1177/0883073817712589. PMID: 28635420

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