Patent Ductus Arteriosus Ligation In Children

What you should know

• Patent Ductus Arteriosus (r-teer-e-O-sus) is called a "PDA." It is a channel or path that connects two large arteries that come out of the top of the heart. The two arteries are called the aorta and the pulmonary artery. Before a baby is born, the PDA is called a Ductus Arteriosus or "DA." The DA is important because it causes most of the blood to bypass the baby's lungs. The lungs do not need much blood since unborn babies do not breathe air. The placenta acts like a lung for unborn babies. After birth, babies do not need the DA anymore because they need blood going to their lungs. The DA is supposed to close shortly after birth. A DA that does not close after birth is called a PDA.
  
  
• After birth, a PDA causes some of the blood from the aorta to leak back into the pulmonary artery. This is not supposed to happen since the blood from the aorta has already been to the lungs once. The circling of blood caused by the PDA makes extra work for the heart and lungs. The heart has to pump harder than normal to send enough blood and oxygen out to the body. In time, this may cause congestive (kun-JES-tiv) heart failure.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

There are always some risks with surgery. Your child may bleed in his head or at the places where the PDA was shut. Your child may get an infection. Your child may get air or blood in his chest or stomach area which could cause bad problems. Your child may get stomach problems. Your child's vocal cords (voice box) may become paralyzed or partly paralyzed. Your child may die. Talk to your caregiver if you are worried or have questions about this surgery.

Getting Ready

The Week Before Surgery:

• You may be given a tour of the ICU before your child's surgery to help you become familiar with where your child will go after surgery.
  
  
• Do not give your child any aspirin or ibuprofen before surgery.
  
  
• Give your child antibiotic (an-ti-bi-AH-tik) medicine before surgery if given to you by your child's caregiver.
  
  
• Tell your child's caregiver about any medicines your child is taking. This includes any over-the-counter medicines like vitamins, herbs, food supplements, or laxatives. Ask your child's caregiver about any medications your child should or should not take before the surgery.
  
  
• Your child may need blood tests before the procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.

The Night Before Surgery:

• Your child should get a good night sleep the night before surgery.
  
  
• Ask caregivers about directions for eating and drinking.

The Day of Surgery:

• Dress your child in loose, comfortable clothing.
  
  
• Write down the date, time, and location of your child's surgery.
  
  
• Ask your child's caregiver before giving your child any medicine on the day of surgery. These medicines include insulin, or heart pills. Bring a list of your child's medicines or the pill bottles with you to the hospital.
  
  
• Your child should not wear contact lenses the day of surgery.Your child may wear glasses.
  
  
• Bring your child's personal belongings with you to the hospital. These include your child's pajamas or bathrobe, toothbrush, hairbrush, slippers, and any special toys or blankets.
  
  
• Leave all of your child's jewelry, such as ear rings, at home.
  
  
• An anesthesiologist (an-iss-thee-z-ALL-o-jist) may talk to you before your child's surgery. This caregiver gives medicine for the surgery that will make your child sleepy. The medicine will keep him from feeling or remembering the surgery.

Treatment

What Will Happen:

• Medicine to help your child relax or make him drowsy may be given through his IV. A caregiver will take your child to the operating room on a wheeled cart or crib. Your child will be given general anesthesia to keep him completely asleep. A caregiver will clean your child's chest with soap and water. An incision (cut) is made between 2 ribs on the left side of your child's chest.
  
  
• Suture (thread) or metal clips are used to close the PDA. The PDA is closed at the aorta end and at the other end close to the pulmonary artery. The incision in your child's chest is closed with wire and stitches (thread) or staples.

After Surgery:

Your child will be taken to the recovery room until he wakes up and is comfortable. You may be able to visit your child in the recovery room after caregivers get him settled. Your child may be able to go home after surgery. If not, your child will then be taken to his room. Your child may be sleepy and have some pain after surgery. Your child should not get out of bed until caregivers say it is OK. You should leave any bandages on your child until a caregiver takes them off.

Waiting Room:

This is a room where you and your family can wait until your child is ready for visitors after surgery. Your child's caregiver can then find you to let you know how the surgery went. If you or your family leave the hospital, leave a phone number where you can be reached.

Contact a caregiver if

• You cannot get your child to his surgery appointment on time.
  
  
• Your child has a fever. Your child's surgery may need to be done later when he is well.
  
  
• The problems for which your child is having surgery get worse.
  
  
• You have questions or concerns about your child's surgery.

Learn more about Patent Ductus Arteriosus Ligation In Children (Precare)