Percutaneous closure of the patent ductus arteriosus: opportunities moving forward

Area of Science:

• Pediatric Cardiology
• Neonatal Medicine
• Interventional Cardiology

Background:

• Patent ductus arteriosus (PDA) closure in infants lacks a universally agreed-upon optimal treatment strategy.
• Surgical ligation risks are known, but evidence for percutaneous closure and conservative management is limited.

Purpose of the Study:

• To systematically review evidence comparing percutaneous closure versus surgical ligation for PDA in infants.
• To compare outcomes of percutaneous closure against conservative management strategies.
• To identify research needs and collaboration opportunities for PDA treatment based on international symposium recommendations.

Main Methods:

• Systematic review of published reports on PDA closure methods in infants.
• Comparative analysis of outcomes between different treatment strategies.
• Synthesis of recommendations from the International PDA Symposium.

Main Results:

• The evidence base for alternative PDA management strategies in infants is not well explored.
• A consensus exists on the need for contemporary clinical trials comparing PDA treatment strategies.
• Quality assurance for new PDA closure devices and standardized data collection are crucial.

Conclusions:

• Further research, including pragmatic clinical trials, is warranted to determine optimal PDA treatment in infants.
• Implementation of new PDA closure devices requires robust quality assurance safeguards.
• Standardized data collection tools are essential for minimizing heterogeneity and enabling pooled analysis across centers.