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.

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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.

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:

  • Ductal-dependent systemic circulation: This category includes hypoplastic left heart syndrome, coarctation of the aorta, and critical aortic stenosis.
  • Ductal-dependent pulmonary circulation: This category includes pulmonary atresia, critical pulmonary stenosis, tricuspid atresia, and severe tetralogy of Fallot.
  • Ductal-dependent systemic and pulmonary circulation: This includes transposition of the great arteries, which means that the two blood vessels leaving the heart aren’t in their usual positions.

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:

  • abnormal heart rate
  • difficulty breathing
  • extreme sleepiness
  • problems feeding

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.

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.