Every baby is born with a ductus arteriosus -- a blood vessel that connects the aorta and pulmonary artery. Because it is not needed after birth, the blood vessel usually closes on its own within the first few days of life. If it doesn’t close, the condition is called a patent ductus arteriosus (PDA). PDA can strain the heart and increase blood pressure in the lungs. Duke pediatric cardiologists and surgeons are experts in diagnosing and treating patent ductus arteriosus safely and effectively. Our pediatric heart program is ranked the best in North Carolina in part because we have the expertise and advanced treatment techniques that are only available at highly qualified hospitals like Duke.

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About Patent Ductus Arteriosus

It’s unknown why some PDAs remain open well after birth, but these congenital heart defects are more common in babies born prematurely and tend to affect premature infants more severely. Left untreated, a PDA may allow too much blood to enter the lung arteries. This forces the heart and lungs to work harder, and it can cause the lungs to become dangerously congested. Symptoms in newborns, which may not occur until several weeks after birth, include:

  • Heart murmur
  • Persistent rapid breathing or breathlessness
  • Poor eating and slow growth
  • Rapid heart rate
  • Sweating while crying or eating

Older children and adults can also be diagnosed with a PDA, as they may not cause issues for decades. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests for PDA

An echocardiogram is the gold standard for diagnosing a patent ductus arteriosus. This specialized ultrasound shows the structure and function of your child’s heart and can help doctors identify the location and size of the open vessel and how much blood is flowing through it.

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PDA Treatment


While not an option for all children, acetaminophen, ibuprofen, or indomethacin may help close a PDA in premature infants.


Most PDAs can be closed using a minimally invasive catherization procedure. While your child is sedated with general anesthesia, a pediatric cardiac interventionalist inserts a thin, flexible tube into a vein and/or artery in the groin and threads it through the circulatory system to the heart. Then, a coil or a plug-like device is inserted to close the PDA. Unlike many centers, Duke offers this option for some of the smallest premature infants.


A pediatric heart surgeon makes a small incision between the ribs and under the left shoulder blade, navigates to the ductus, and places a permanent metal clip or stitch to squeeze the vessel closed. Our surgeons can perform this short surgery at the child’s bedside in the Neonatal Intensive Care Unit (NICU) for fragile newborns or in an operating room for larger infants and children.

Why Choose Duke

More Options for Premature Infants
Duke offers a minimally invasive catheterization procedure and a plug-like device that was FDA-approved in 2019 for PDA closure in tiny infants (those who weigh more than 700 grams, which is about 24 ounces). This option may have less risk than surgery and could make PDA closure more common in these babies, helping to prevent or reduce their risk for lung disease and pulmonary hypertension. Duke’s specialized team of neonatologists, respiratory therapists, pediatric cardiac interventionalists, cardiologists, imagers, anesthesiologists, surgeons, and more work together to identify children who could benefit from this procedure, transfer them safely to and from the catheterization lab, and monitor their progress.

Recognized for Excellence
Duke Children’s Hospital is verified as a Level I Children's Surgery Center by the American College of Surgeons. This Level I designation recognizes our commitment to providing the safest and highest-quality surgical care to our young patients.

A gold badge shows Duke has been nationally ranked in 10 pediatric specialties for 2023 to 2024
#2 in Nation and #1 in NC for Pediatric Cardiology and Heart Surgery

Duke Children’s is ranked the #2 pediatric cardiology program in the nation and the best in North Carolina by U.S. News & World Report.

This page was medically reviewed on 01/04/2023