Transcatheter closure of PDA: how the pathway changed from classical fluoroscopy approach

Patent ductus arteriosus (PDA) is a common congenital cardiac defect traditionally managed by surgical and transcatheter closure under fluoroscopic guidance. Over recent years, significant advances in imaging modalities, device technology, and procedural planning have transformed the pathway for PDA closure, reducing reliance on classical fluoroscopy-based techniques. This review outlines the evolution of transcatheter PDA closure from conventional fluoroscopic approaches to contemporary strategies incorporating echocardiographic guidance, hybrid imaging, and radiation-sparing protocols. These changes have enhanced procedural safety, reduced radiation exposure to patients and operators, shortened procedure times, and expanded eligibility to younger and higher-risk populations. Understanding this evolving pathway is essential for optimizing outcomes and guiding future practice in transcatheter PDA closure.