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Review
. 2024 Oct;44(10):1402-1408.
doi: 10.1038/s41372-024-02052-9. Epub 2024 Jul 12.

Procedural closure of the patent ductus arteriosus in preterm infants: a clinical practice guideline

Souvik Mitra #  1 , Adrianne R Bischoff #  2 , Shyam Sathanandam  3 , Satyan Lakshminrusimha  4 , Patrick J McNamara  5
Affiliations
Review

Procedural closure of the patent ductus arteriosus in preterm infants: a clinical practice guideline

Souvik Mitra et al. J Perinatol. 2024 Oct.

Abstract

Importance: Transcatheter closure of the patent ductus arteriosus (PDA) is being increasingly adopted as an alternative to surgical PDA closure in preterm infants.

Objective: To develop rigorous clinical practice guideline recommendations on procedural PDA closure in preterm infants.

Methods: The principles of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence-to-Decision (EtD) framework were used to develop the guideline recommendations. An e-Delphi survey of 45 experts was conducted and recommendations that reached ≥75% agreement were accepted as consensus.

Main recommendations: Procedural PDA closure may be considered in extremely preterm infants (<28 weeks gestational age) requiring invasive mechanical ventilation >10 postnatal days and confirmed to have a large hemodynamically significant PDA, at centers with high local rates of death and/or bronchopulmonary dysplasia (conditional recommendation). If sufficient institutional expertise is available and patient characteristics are suitable, transcatheter PDA closure may be considered as the preferred approach over PDA ligation (conditional recommendation).

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References

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    1. Benitz WE, Committee on Fetus and Newborn, American Academy of Pediatrics. Patent ductus arteriosus in preterm infants. Pediatrics. 2016;137:e20153730.
    1. Mitra S, de Boode WP, Weisz DE, Shah PS. Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of cochrane systematic reviews. Cochrane Database Syst Rev. 2023;4:CD013588. - PubMed
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