What is the life expectancy for adults with PDA?

Life Expectancy and Risks of PDA in Adults

Patent ductus arteriosus (PDA) is a condition where a blood vessel that should close shortly after birth remains open. In adults, the prognosis largely depends on the size of the PDA. Those with a small PDA often have a normal life expectancy and may live symptom-free without major complications. However, even in these cases, medical guidelines recommend intervention under certain conditions.

According to Dutch clinical guidelines, closing the PDA is advised when a heart murmur is present, even if symptoms are mild. The main reason? To prevent a rare but serious complication called endarteritis—an infection of the inner lining of the heart or blood vessel. In PDA patients, this infection can lead to the formation of vegetations, which are clumps of bacteria and tissue. These typically develop on the pulmonary side of the ductus, where turbulent blood flow creates a favorable environment for bacterial colonization.

While the risk of systemic embolism (clots traveling to the brain or limbs) is low, embolic events in PDA cases usually remain confined to the lungs due to the left-to-right shunt direction. This means clots or infected material from the vegetation are more likely to lodge in the pulmonary circulation rather than entering the broader systemic system. Still, pulmonary embolization can lead to complications such as infarcts or recurrent infections, underscoring the importance of early intervention.

For most adults diagnosed with PDA, closure—either through catheter-based procedures or surgery—offers a preventive solution with low risk and high success. Once closed, patients can continue to enjoy a normal life expectancy with regular follow-up. The key takeaway: even asymptomatic PDAs warrant attention, not because they shorten life, but because timely management can prevent potentially serious complications down the line.