PDA Closure

A thorough diagnosis and evaluation are necessary before PDA closure using either operative or catheter-based approach. An extensive evaluation is conducted to check for the presence of other congenital deformities or defects.

The following are some of the tests that may be conducted to check for the overall fitness of the patient or confirm the presence of other congenital malformations:

• Radiography findings help determine the size of the PDA (small, medium, or large)
• A 2-dimensional echocardiography is used to visualize the aortic end of the PDA. This test provides detailed information about congenital cardiovascular malformations.
• Electrocardiographic (ECG) findings help confirm atrial enlargement or ventricular hypertrophy in patients with large PDA.
• Cardiac catheterization is conducted when other congenital malformations are observed in the other tests.
• Selective angiography help determine the intracardiac anatomy and the size of the PDA.

PDA closure is performed under the influence of general anaesthetic (GA) using the heart catheterization procedure. During the closure, the surgeon places a closure device into the catheter.

A typical PDA closure device is made up of mesh and metal material. It is a short tube with discs of different sizes in both its ends. The device is folder before its insertion into the catheter. The device is moved out of the catheter upon reaching the right place. One of the appropriate discs opens up when the device is moved out of the catheter. It’s acts like a plug and seals off the PDA, stopping the flow of oxygenated blood to the pulmonary artery.

The catheter is usually inserted into a blood vessel in the groin region. The catheter is gently moved up to reach the site of PDA. The closure device is threaded through to reach the PDA site and is placed in the targeted position. Once the device is in place, the catheter is withdrawn and the site of catheter insertion is bandaged.

The procedure takes anywhere from one to three hours to complete. As soon as the procedure is over, the child is transferred to the recovery room and is kept there as long as the effect of the GA fades off. Most of the children are discharged on the same day as that of PDA closure procedure. However, they will be required to stay in the hospital for at least four to six hours after the surgery.

Some children, however, will be required to stay in the hospital overnight. They are transferred to the inpatient unit after the effect of the GA is over. A chest X-ray is conducted the next day in the case of all patients to check the position of the closure device. Children who are discharged on the same day of the procedure must be brought to the hospital again in the next morning for the X-ray.

The surgeon may prescribe a few antibiotics after the surgery to prevent heart infection known as infectious endocarditis. It is common for premature infants or infants with larger PDA to become tired feeding. Therefore, care must be taken to high-calorie formula or breast milk to them for normal growth and development.

Cost of Patent Ductus Arteriosus (PDA) Closure

The PDA closure surgery cost in India depends on a number of factors. However, the total cost is still much reasonable and affordable as compared to the Western countries. The total PDA closure surgery cost in India may depend on the quality of the closure device used, the type of approach used for the surgery (surgical or catheterization), the duration of hospital stay and the cost of additional tests conducted, among other factors.

The following table highlights the cost of PDA closure surgery in India and some of the other popular medical tourism destinations: