Principles of treatment for patent ductus arteriosus in neonates

The treatment principles for patent ductus arteriosus in newborns include drug therapy, surgical treatment and interventional treatment. The specific method should be determined according to the severity of the disease and physical condition of the child. Patent ductus arteriosus is a common heart problem in newborns, and timely intervention can effectively improve the prognosis.

1. Drug treatment

Drug treatment is suitable for children with mild symptoms or who are temporarily unable to undergo surgery. Commonly used drugs include:

Prostaglandin inhibitors: such as indomethacin, promote ductal closure by inhibiting prostaglandin synthesis.

Diuretics: such as furosemide, used to reduce the burden on the heart and relieve edema symptoms.

Cardiotonic drugs: such as digoxin, used to improve heart function and suitable for children with concomitant heart failure.

2. Surgical treatment

For children who are not responsive to drug treatment or whose condition is more serious, surgery is the main option. Common surgical methods include:

Duct ligation: Direct ligation of the unclosed ductus arteriosus through open-chest surgery. Suitable for children with thick ductus or other combined heart malformations.

Thoracoscopic surgery: a minimally invasive surgical method with small trauma and quick recovery, suitable for children with stable conditions.

Open heart surgery: It is suitable for children with complex heart malformations and needs to be performed under extracorporeal circulation.

3. Interventional treatment

Interventional therapy is a minimally invasive approach suitable for children with small catheter diameters and stable conditions. Commonly used techniques include:

Catheter occlusion: An occluder is inserted into the unclosed ductus arteriosus through a catheter to block blood flow and promote closure.

Coil embolization: Suitable for children with smaller catheter diameters, closure is achieved by embolizing the catheter with a coil.

Balloon angioplasty: Used in special circumstances to dilate narrowed ducts and improve blood flow.

The treatment of patent ductus arteriosus in newborns should be based on the specific situation. Mild children can be treated with medication to observe the changes in their condition, while moderate to severe children need surgery or interventional treatment as soon as possible. Parents should closely observe the child's breathing, heart rate and feeding conditions, and seek medical attention in time if any abnormalities are found. During the treatment process, regular follow-up and cardiac function assessment are essential to ensure that the child obtains the best treatment effect and long-term prognosis.