Pediatrics Procedure (CASD, PDA CLOSURE)
How is PDA surgery performed?
For the surgery, your child will be given medicine so that he or she will sleep and not feel any discomfort. The surgeon will make a small cut between your child’s ribs to reach the PDA. He or she will then close the PDA with stitches or clips. Complications from surgery are rare and usually short term.
How long does PDA surgery take?
The procedure takes about one to three hours The procedure usually takes one to three hours. After the procedure, your child will go to the recovery room for one to six hours to wake up from the anaesthesia.
How we treat PDAs
- Observation: Doctors will closely monitor the heart and blood vessel to determine whether the PDA is closing properly or too small to cause a problem.
- Medication: In premature infants, an intravenous (IV) medication called indomethacin may help close a PDA.
- Open-heart surgery: Doctors can also close a PDA through open-heart surgery, where they open the chest between the ribs to tie off or clamp the duct. Babies who have heart surgery face more risk and longer recovery time.
- Transcatheter closure: Doctors can insert a soft, wire mesh PDA closure device through a catheter (a long, narrow tube) to stop blood flow through a PDA.
What is transcatheter PDA closure?
A transcatheter PDA closure is a minimally-invasive (non-surgical) procedure to close the ductus arteriosus. Specialized heart doctors called pediatric cardiac interventionists use a procedure called cardiac catheterization to place a small device in the vessel, which closes the PDA.
This procedure is also called “minimally-invasive PDA closure” or “PDA occlusion.” (Occlusion means blocking or closing a blood vessel.)
Transcatheter vs. surgical closure of PDA
For many babies, a transcatheter PDA closure is usually preferable to open-heart surgery because it presents less risk and shorter recovery time. Premature babies who have surgery to close their PDA may face a difficult recovery in the Neonatal Intensive Care Unit (NICU). Babies who have the non-surgical PDA closure procedure usually recover quickly and with little disruption to their other neonatal care.
What to expect after non-surgical PDA closure
After the procedure, we will bring your baby back to the NICU where we will monitor them closely for the next 24 to 48 hours. Circulation, breathing and feeding should improve soon after the procedure.
Your baby may experience some discomfort at the catheter access point. Our care team will keep a close eye on your child to ensure they are comfortable.
Following PDA closure, we will continue to care for your baby in the NICU until they are well enough to go home.
What Is New?
- The current study provides empirical measurements of the cost of pediatric/congenital cardiac catheterization laboratory procedures, demonstrating large‐scale differences in the cost of these procedures between hospitals that are not explained by case‐mix or procedural volume in most cases.
- Hospitals with high costs for one procedure were more likely to also have high costs for other procedures.
- Interhospital variation in cost is likely caused by both differences in the efficiency of the delivery of healthcare services and catastrophic adverse outcomes that result in protracted and expensive hospitalizations.
