Ochsner Hospital for Children is the only program in Louisiana, Mississippi, and Alabama to offer a noninvasive solution for extremely low birth weight (under 1000 grams or two pounds, three ounces) babies with a structural heart condition known as patency of the ductus arteriosus (PDA).
All newborns have a blood vessel called a ductus arteriosus that directs blood to go around the developing lungs while a baby is in the womb. If functioning properly, this blood vessel naturally closes in the first few days after delivery. When this blood vessel fails to close on its own, too much blood is directed to the lungs of the baby instead of going to other parts of the body. If left untreated, a PDA causes both the heart and lungs to work harder than normal, resulting in difficulty breathing, feeding problems, blood circulation issues, or even heart failure.
Signs a baby may have a PDA include rapid breathing and a forceful pulse. To check for a PDA, a doctor uses a stethoscope to listen for a heart murmur before obtaining x-rays and an echocardiogram to confirm the diagnosis and size of the blood vessel. Depending on the size of the PDA, some babies may only require observation in the neonatal intensive care unit (NICU), while others may need medicine or even surgery.
Working closely with neonatologists at Ochsner Baptist – A Campus of Ochsner Medical Center, the pediatric cardiology team at Ochsner Hospital for Children offers a non-invasive alternative to surgery – performing the PDA closure in a catherization lab (cath lab) on babies with extreme low birth weight, as small as 550 grams (below 1.5 pounds). During the procedure, a small tube (or catheter) is inserted into a blood vessel in the baby’s leg and carefully guided up to the heart. Attached to the catheter is a pea-sized closure device made of a self-expanding mesh alloy called an Amplatzer Piccolo™ Occluder that is used to plug the blood vessel (ductus arteriosus), thereby stopping the extra blood flow to the lungs.
“Offering noninvasive PDA closures delivers powerful results with less recovery time. It has made a huge difference in the wellbeing and overall health of the babies we care for, especially those with low or extreme low birth weight. Ochsner has become a destination – both across the state and beyond – for PDA closures for premature babies. It’s one of the many reasons why we are a leader for pediatric cardiac care in our region,” said Ivory Crittendon, III, MD, senior physician, pediatric cardiology, Ochsner Hospital for Children.
Approximately one in every 12 babies is born with a low birthweight (five pounds, eight ounces or less). Although babies born full term can have a PDA, it is more commonly found in babies born prematurely (before 37 weeks gestation). Across the United States, one in every 10 babies is born premature. In Louisiana, that number is even higher with a 13 percent preterm birth rate, making it the second-highest state in the country for preterm births.
“As Louisiana’s only level IV NICU with a level IV labor and delivery unit, we care for some of the most critically ill babies in our State. Many of these patients are born preterm and some have extremely low birth weights,” said Harley Ginsberg, MD, section head, neonatology, and Medical Director of the NICU at Ochsner Baptist Medical Center. “To be able offer them and their family this procedure (transcatheter occlusion) instead of invasive surgery has been a true gamechanger for these little ones. The follow up chest x-rays frequently show prompt improvement of lung function and rarely are any pain medications required after the procedure. With a shorter recovery time, babies resume feedings sooner and tend to wean more rapidly from ventilatory support.”
Cardiology at Ochsner
For the third year in a row, Ochsner Hospital for Children has been named among the top 50 children’s hospitals in the country by U.S. News & World Report. Ochsner Hospital for Children was recognized in two specialties, cardiology and heart surgery, and gastroenterology and gastrointestinal surgery.
Ochsner offers the only pediatric heart transplant program in the state of Louisiana and its Pediatric and Adult Congenital Cardiac Surgery Program’s 2018 surgical outcomes greatly exceeded national averages. Ochsner achieved 100% survival in neonatal and child heart surgeries and in the Norwood Procedure, used to treat hypoplastic left heart syndrome.