Closure of the PDA
There are different ways to treat a PDA defect. At first, the symptoms from the PDA defect can be regulated with medication however this is only a transient method without treating the underlying cause. Other ways to treat a PDA defect are by heart surgery or catheter-based procedures, i.e. interventional treatment.
The closure is performed in a cardiac catheterization laboratory, known as a cath lab. Techniques vary between clinics and physicians active in catheter interventions. In older patients the procedure can be done under local anesthesia. In younger patients, patients who are afraid and in all children, the procedure is performed with the support of sleeping medication (sedation) or by general anesthesia. The procedure itself will be performed by a specialist in treating congenital heart defects, a (pediatric) cardiologist.
A thin tube – a catheter – is inserted into a blood vessel in the groin and guided to the heart. As the shape of a PDA can vary substantially, the size, diameter and length of the PDA is measured exactly by angiography. Thereafter a special closure device, a PDA occluder is chosen. The procedure is constantly monitored by X-ray. The catheter is then exchanged for a larger catheter and a delivery sheath is placed across the PDA. The appropriate device, a PDA occluder, is pushed through the delivery sheath to be placed correctly inside the PDA to close the defect. After placement, the physician will check the position by repeat angiography, release the device and withdraw the delivery sheath. Typically the procedure takes around 60 minutes. The defect is now closed and the tissue will grow around the device.