Patent ductus arteriosus: Are we finally asking the right question?

PDA management should move beyond anatomical diagnosis toward assessment of physiological significance. The PLASE study demonstrates that early PDA-related hemodynamics are associated with neurodevelopment at three years of age. Current evidence suggests that ductal closure alone does not consistently improve long-term clinical outcomes. Future clinical trials should identify infants most likely to benefit using physiology-guided patient selection. The ultimate goal of PDA management should be improving long-term neurodevelopment and other outcomes that matter to children and families.