Patent ductus arteriosus medical therapy in term and older children

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Overview

In term infants and older patients, the prostaglandin E2 inhibitors (indomethacin and ibuprofen) have not shown to be effective. This is so because the ductus in premature baby is different histological from in older patients. As a result, pharmacologic therapy is only used routinely in preterm infants.

2008 ACC/AHA Guidelines for the Management of Adults with Congenital Heart Disease (DO NOT EDIT)[1]

2008 ACC/AHA Guidelines for the Management of Adults with Congenital Heart Disease (DO NOT EDIT)^[1]

Recommendations for Medical Therapy (DO NOT EDIT)^[1]

Class I
“1. Routine follow-up is recommended for patients with a small PDA without evidence of left-sided heart volume overload. Follow-up is recommended every 3 to 5 years for patients with a small PDA without evidence of left-heart volume overload.(Level of Evidence: C) ”

Class III (Harm)
“1. Endocarditis prophylaxis is not recommended for those with a repaired PDA without residual shunt. (Level of Evidence: C) ”

References

↑ ^1.0 ^1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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[pmid19038677-1] 1.0 ^1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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