Uncorrected heart defect ups risk of infant death

Infants born with a congenital heart defect that goes uncorrected have a higher risk of dying than their counterparts who have the heart defect corrected. The birth heart defect known as patent ductus arteriosus, or PDA, afflicts mainly infants who are born very prematurely. The defect occurs when a large blood vessel near the heart - the ductus arteriosus - fails to close at birth. The condition leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels surrounding the heart. No study in the past has investigated the outcome persistently open ductus arteriosus on infants. To examine the possible impact of the failure to close the PDA, researchers from California studied 301 infants who were born prematurely weighing 1500 grams or less. The 41 infants with a persistently open ductus arteriosus had lower birth weight and were less mature than the 260 infants with a closed ductus arteriosus. It was found was that preterm infants whose ductus arteriosus failed to close either spontaneously or with medication had an eight-fold increase in risk of dying during the initial hospital stay. The death rate was 70 percent in infants with an open ductus arteriosus versus 11 percent in those with a closed ductus arteriosus. The increased risk of mortality was noted even when known risk factors for death such as degree of prematurity and infection were taken into account. Although the above findings do not establish the patent ductus arteriosus as the cause of increased mortality, it strongly raises this possibility.

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