Can a Patent Ductus Arteriosus Heal on Its Own?

The ductus arteriosus is a blood vessel that connects the descending aorta and the pulmonary artery. Normally, this passage should close shortly after birth. If a fetal ultrasound or neonatal echocardiogram detects a patent ductus arteriosus (PDA), there is still a high chance of spontaneous closure. In most cases, the ductus begins to close functionally within about 10 hours after birth. This closure is triggered by increased oxygen levels in the blood, which cause the smooth muscle in the vessel wall to contract, narrowing the lumen and preventing blood flow through the ductus.

What Happens After Birth?

Within the first three months of life, approximately 80% of infants will experience complete anatomical closure of the ductus arteriosus, meaning the vessel fully transforms into a fibrous cord. By the time the child reaches one year of age, about 90% of PDAs will have closed naturally, with no residual blood flow. However, if the ductus remains open beyond the first year, the likelihood of spontaneous closure becomes extremely low.

When Medical Intervention Is Necessary

If the ductus remains patent beyond 12 months, medical treatment is typically required. In such cases, doctors may recommend either catheter-based intervention or surgical ligation to close the vessel. Waiting for a spontaneous closure is generally not advised, as the chances are minimal. For infants under one year old, a "wait-and-see" approach may be appropriate, especially if the PDA is small and not causing symptoms.

However, in cases where the PDA is large—measuring 8–10 mm or more—early intervention is crucial. A large PDA can lead to significant complications such as heart failure, pulmonary hypertension, and recurrent respiratory infections like pneumonia. These infants may require prompt treatment to prevent long-term damage to the heart and lungs.

In summary, while many cases of PDA close naturally within the first year of life, timely monitoring and medical evaluation are essential. Parents should work closely with pediatric cardiologists to determine the best course of action based on the size of the ductus, the presence of symptoms, and the overall health of the child.