Patent ductus arteriosus in Qatar: a retrospective study on epidemiology and neonatal outcomes following transcatheter closure

Patent ductus arteriosus (PDA) is a congenital heart defect resulting from failure of the ductus arteriosus to close after birth. It is particularly common in preterm infants and may become hemodynamically significant, requiring intervention. Transcatheter device closure offers a minimally invasive treatment option, though it can be technically challenging in this population.

This retrospective study included 80 infants diagnosed with PDA at Sidra Medicine, Qatar, between 2018 and 2024. Data were obtained from electronic health records. Patients who underwent medical treatment or transcatheter device closure were included, while those requiring surgical intervention were excluded. Variables collected included gestational age, birth weight, comorbidities, and PDA characteristics. Outcomes assessed were implant success and complications. Statistical analysis was performed using SPSS version 29, with significance set at p ≤ 0.05.

Of the 80 patients, 60% were male and 83.75% were born prematurely (<37 weeks gestation). Transcatheter device closure was performed in 52 patients (65%). Gestational age <37 weeks was significantly associated with catheter-based treatment (p ≤ 0.05). The presence of a PDA murmur increased the likelihood of catheter-based intervention eightfold (OR 8.125; p < 0.001), and larger PDA diameter was also a significant predictor (OR 4.628; p < 0.001). Among those undergoing transcatheter closure, implant success was achieved in 45 of 52 patients (86.5%) on the first attempt and in all patients (100%) after repeat intervention. Intraprocedural complications included device embolization in 4 patients. Residual shunt was observed immediately post-procedure in 11 patients (21.2%) but resolved in all 48 patients with six-month follow-up data. Time to discharge correlated negatively with gestational age (R =-0.365; p = 0.014) and birth weight (R =-0.383; p = 0.011). Non-procedure-related mortality occurred in 5 patients (9.6%).

PDA closure demonstrates high procedural success and acceptable safety in preterm infants. Key factors influencing intervention and outcomes include gestational age, birth weight, and ductal size. These findings support the feasibility of transcatheter approaches in this vulnerable population, while highlighting the importance of patient selection and clinical characteristics in predicting outcomes and hospital course.