ACC/AHA recommendations for closure of patent ductus arteriosus

Class I

1.Closure of a PDA either percutaneously or surgically is indicated for the following:

1. Left atrial and/or LV enlargement or if PAH is present, or in the presence of net left-to-right shunting. (Level of Evidence: C)

2. Prior endarteritis. (Level of Evidence: C)

2. Consultation with adult congenital heart disease (ACHD) interventional cardiologists is recommended before surgical closure is selected as the method of repair for patients with a calcified PDA. (Level of Evidence: C) 3. Surgical repair by a surgeon experienced in CHD surgery is recommended when:

1. The PDA is too large for device closure. (Level of Evidence: C)

2. Distorted ductal anatomy precludes device closure (e.g., aneurysm or endarteritis). (Deanfield et al., 2003) (Level of Evidence: B)

Class IIa

1. It is reasonable to close an asymptomatic small PDA by catheter device. (Level of Evidence: C) 2. PDA closure is reasonable for patients with PAH with a net left-to-right shunt. (Level of Evidence: C)

Class III

1. PDA closure is not indicated for patients with PAH and net right-to-left shunt. (Level of Evidence: C)

External links

• Fetal Circulation at berkeley.edu
• Goldminer: Patent ductus arteriosus