Ductal-Dependent Congenital Heart Disease: Symptoms and Outlook
Ductal-dependent congenital heart disease involves a problem with the arteries that carry blood out of the heart. It’s usually discovered soon after birth, but medications and treatments can help manage it.
Ductal-Dependent Congenital Heart Disease: Symptoms and Outlook
Congenital heart disease can range from mild heart defects to more serious conditions.
Ductal-dependent congenital heart disease involves an irregularity with the ductus arteriosus, an opening between the aorta and the pulmonary artery. This issue means that blood can’t flow as easily through it.
Medications can help maintain blood flow, and, later, surgery can correct the irregularity.
What is ductal-dependent congenital heart disease?
While a fetus is in the womb, the ductus arteriosus stays open. This means that blood can easily flow between the heart and the rest of the body.
Usually, the opening between the pulmonary artery (which carries blood to the lungs) and the aorta (which delivers blood to most of the body) closes soon after birth. This ensures that oxygen-rich blood circulates throughout the body.
However, if the fetus has congenital heart disease, it means that there are problems with their blood vessels, valves, or other heart structures.
Doctors usually divide ductal-dependent congenital heart disease into three categories:
Although some infants have obvious symptoms when they’re born, this isn’t always the case. That means it’s important that new parents and caregivers watch their infant closely for any indications of a possible issue.
One of the most obvious symptoms is cyanosis, a bluish tint to the skin. This happens because of unusually low oxygen levels in the blood.
Other common symptoms of ductal-dependent congenital heart disease to look out for include:
In most cases, experts don’t know why congenital heart defects happen.
Research suggests that about 15–20% of newborns with critical congenital heart disease have changes in their chromosomes that trigger the birth irregularities.
One theory is that genetics play a role. Other possible risk factors include the birthing parent’s exposure to chemicals, toxins, or medications during pregnancy.
If an infant receives a diagnosis of ductal-dependent congenital heart disease, the priority is keeping the ductus arteriosus open before a doctor can treat the irregular valve, blood vessel, or other problem.
One 2019 study suggests that a continuous, low dose infusion of the medication prostaglandin-E1 can help. This medication helps the smooth muscle tissue of the ductus arteriosus relax, which keeps blood flowing easily.
Additionally, a 2021 study suggests that placing a stent within the ductus arteriosus can be a safe and effective means of keeping the duct open.
Other treatments depend on the nature of the congenital heart disease, though most involve surgery. For some infants, that means closing a hole between the atria (the heart’s upper chambers) or ventricles (the heart’s lower chambers).
Many types of congenital heart disease require additional surgeries or treatments as the infant grows. Your pediatrician can recommend the best course of treatment for your child’s long-term health.
Successful treatment can lead to a long, active life. Ongoing medical care is usually required to monitor any changes in heart function or complications stemming from the congenital heart disease.
According to the Centers for Disease Control and Prevention (CDC), about 93% of people with congenital heart disease who survive their first year of life will reach at least 35 years old. However, about 40% of adults with congenital heart disease have some kind of physical or cognitive disability.
It’s important to note that outlook is individual and depends on the type of heart defect someone has and how a doctor treats it. Always speak to your child’s doctor about their treatment plan and long-term goals.
FAQ for Ductal-Dependent Congenital Heart Disease
What is ductal-dependent congenital heart disease?
Ductal-dependent congenital heart disease involves an irregularity with the ductus arteriosus 1 2, an opening between the aorta and the pulmonary artery 3. This condition affects the arteries that carry blood out of the heart 3, making it difficult for blood to flow properly. [Source: American Heart Association]
What are the types of ductal-dependent congenital heart disease?
Doctors categorize ductal-dependent congenital heart disease into three types:
1 3. Ductal-dependent systemic circulation: Includes hypoplastic left heart syndrome, coarctation of the aorta, and critical aortic stenosis.
2. Ductal-dependent pulmonary circulation: Includes pulmonary atresia, critical pulmonary stenosis, tricuspid atresia, and severe tetralogy of Fallot.
3. Ductal-dependent systemic and pulmonary circulation: Includes transposition of the great arteries, where the two blood vessels leaving the heart are not in their usual positions. [Source: Mayo Clinic]
What are the symptoms of ductal-dependent congenital heart disease?
Common symptoms include:
What causes ductal-dependent congenital heart disease?
The exact cause is often unknown 3, but potential factors include:
- Genetic changes in chromosomes
- Exposure to chemicals, toxins, or medications during pregnancy [Source: CDC]
How is ductal-dependent congenital heart disease diagnosed?
Diagnosis typically occurs soon after birth through physical examination and imaging tests such as echocardiograms3. [Source: American Heart Association]
What treatments are available for ductal-dependent congenital heart disease?
Initial treatment focuses on keeping the ductus arteriosus open using:
- Prostaglandin-E1 infusion 34: Helps relax the smooth muscle tissue of the ductus arteriosus to maintain blood flow. [Source: National Institutes of Health (NIH)]
- Stent placement: Keeps the ductus arteriosus open. [Source: NIH]
Long-term treatment often involves surgery to correct the heart defect, such as closing holes between the heart’s chambers or repairing valves and blood vessels. [Source: Mayo Clinic]
What is the outlook for children with ductal-dependent congenital heart disease?
With successful treatment 3, many children can lead long, active lives. Ongoing medical care is essential to monitor heart function and manage any complications. According to the CDC, about 93% of people with congenital heart disease who survive their first year will reach at least 35 years old. However, around 40% of adults with congenital heart disease may have some physical or cognitive disabilities. [Source: CDC]
How can parents manage ductal-dependent congenital heart disease in their child?
Parents should:
- Follow the treatment plan prescribed by their pediatrician.
- Ensure regular medical check-ups to monitor the child’s heart condition.
- Be aware of symptoms that may indicate complications and seek immediate medical attention if they occur 3. [Source: American Heart Association]
What are the long-term care needs for children with ductal-dependent congenital heart disease?
Long-term care may include:
Can ductal-dependent congenital heart disease be prevented?
While the exact cause is often unknown 3, pregnant individuals can reduce the risk by:
- Avoiding exposure to harmful chemicals and toxins.
- Managing chronic health conditions.
- Following a healthy lifestyle during pregnancy. [Source: CDC]
By understanding and managing ductal-dependent congenital heart disease3, parents can help their children lead healthier lives. For more information and resources, consult healthcare providers and reputable organizations like the American Heart Association and the CDC.
The bottom line
The initial treatment for ductal-dependent congenital heart disease is either a stent or a prostaglandin-E1 infusion to keep the duct open and the blood flowing.
From there, it’s up to a pediatrician to map out a longer-term treatment plan.
Congenital heart defects may require a lifetime of care. But as technology and physician expertise continue to improve, so too do the odds of infants born with such a condition living a long, active life.
