Transcatheter Closure Of Patent Ductus Arteriosus

The ductus arteriosus is the vascular remnant of the left sixth aortic arch, connecting the main pulmonary artery to the aorta. A patent ductus arteriosus (PDA) is the persistent opening of the channel beyond its expected time of closure during the first few days of life. Catheter-based techniques have been developed to close PDAs to eliminate the need for general anesthesia, a thoracotomy, and an extended hospital stay and convalescence associated with open surgical PDA closure. The use of percutaneous closure devices has become the procedure of choice for closure of patent ductus arteriosus in suitable patients. The evidence base for percutaneous closure of PDAs consists of a large number of case series that report high success rates with low rates of adverse events. A few nonrandomized comparative trials compare outcomes of different devices and techniques, and one such study reports better outcomes with a thoracoscopic approach compared to a percutaneous approach. However, these nonrandomized studies are not adequately rigorous to form conclusions because there is a high likelihood of selection bias, resulting in populations that are not comparable. Based on the evidence that percutaneous closure achieves high success rates and avoids the morbidity of open surgery, this technique may be considered medically necessary. <a id="