Patent Ductus Arteriosus

T Jasmine Rajareegam Princely1, Ramunapriya2,

1Ward Incharge, Kauvery Heartcity, Trichy, India

2Senior Staff Nurse, Kauvery Heartcity, Trichy, India

*Correspondence: nursing.heartcity@kauveryhospital.com

Background

Patent Ductus Arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart.  The opening (Ductus Arteriosus) is a normal part of a baby’s circulatory system in the womb that usually closes shortly after birth. If it remains open it’s called a Patent Ductus Arteriosus.

Case Presentation

Baby S, 1-year-old child, was a known case of congenital acyanotic heart disease PDA, and was admitted for PDA device closure.

Baby had been delivered a year earlier, by normal delivery, with a birth weight of 3.04 kg (37 week). After the birth child’s milestones were normal. After 6 months child developed recurrent common colds and poor weight gain due to poor intake of food. Initially, they went nearby hospital and treated for a common cold later shown to Pediatric Cardiologist at Heart City who advised early PDA closure. The parents were not in consanguineous marriage.

On examination, she was found to be conscious and oriented.

Vitals

Within normal limits

How to Diagnosis

  1. ECHO cardiogram
  2. Chest X-ray
  3. Electrocardiogram
  4. Cardiac Catheterization

ECHO Report

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ECG

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Diagram of PDA

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Procedure Notes

RFV access was obtained and 500 IU Heparin administered

The PDA was crossed with a multipurpose catheter and straight Terumo wire cannulation.

7Fr Balkins sheath was advanced into the descending aorta

A Ductal angiogram revealed a 3.75 mm PDA

A 06 x 08 mm Ductal occluder was deployed across the PDA.  There was no obstruction of LPA or aortic obstruction on echocardiogram

The device was released, sheath removed and homeostasis secured.

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Nursing Management

  1. Explained about the procedure to the parents.
  2. Provided psychological support.
  3. Maintained interpersonal relationship with patient and family members.
  4. A diversional therapy like listening to music and television was introduced.
  5. AIDET communication technique was followed for effective communication.
  6. Strict compliance with HICC standard precautions was ensured.
  7. Necessary investigations were done on a daily basis to monitor his health improvement.
  8. The assigned nurses communicated with the parents

    , reassuring him about his health status and explaining pre-cart preparation to parents.

  9. Nurses coordinated with other health care professionals for care while doing X-ray, arranging diet at appropriate time and for other timely investigations.
  10. After receiving from Cath lab Monitored vital sign Q4 Hrly and recorded.
  11. The nurses assessed the skin integrity of the patient on a daily basis to prevent dehydration or skin tear.
  12. Maintained adequate cardiac output.
  13. Maintained adequate levels of activity.
  14. Provided support for growth and development.
  15. Maintained appropriate weight and height development.

Discharge Advice

Instructed the parents about activity restrictions based on the child’s tolerance and energy levels.  Advised the parents not to be overprotective as the child’s tolerance for physical activity increases.  Need for regular follow-up examinations.  We advised to take normal diet.

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Ms. Jasmine Rajareegam Princely,

Ward Nursing Incharge

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Ms. Ramunapriya

Senior Staff Nurse

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