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Review
. 2025 Apr 10.
doi: 10.1007/s00246-025-03834-4. Online ahead of print.

Stenting the Ductus Arteriosus in Neonates with Ductal-Dependent Pulmonary Blood Flow: Technical and Anatomic Considerations

Tacy E Downing  1 , Dana M Boucek  2 , Andrew C Glatz  3 , Athar M Qureshi  4 , Jeffrey D Zampi  5 , Christopher J Petit  6 , Mark A Law  7 , Jeffery J Meadows  8 , Michael L O'Byrne  9 , George T Nicholson  10 , Shabana Shahanavaz  11 , Shiraz A Maskatia  12 , Bryan H Goldstein  13 , Brian H Morray  14 ; Congenital Cardiac Research Collaborative
Affiliations
Review

Stenting the Ductus Arteriosus in Neonates with Ductal-Dependent Pulmonary Blood Flow: Technical and Anatomic Considerations

Tacy E Downing et al. Pediatr Cardiol. .

Abstract

Patent ductus arteriosus (PDA) stenting is rapidly emerging as an initial palliative option for infants with cyanotic congenital heart disease and ductal-dependent pulmonary blood flow. Although less invasive than surgical systemic to pulmonary shunt placement, the procedure is technically challenging with a notable learning curve. The highly variable anatomy of the PDA contributes to procedural complexity, success rates, and adverse outcomes. This technical review proposes a scheme of best practices for PDA stenting based on the authors' experience and existing literature. We review pre-, intra-, and post-catheterization care, with an in-depth discussion of procedural strategy, equipment selection, and technical pitfalls relevant to each morphologic PDA sub-type.

Keywords: Catheterization; Ductal artery stent; Ductus arteriosus; Pulmonary atresia; Stent angioplasty; Tetralogy of Fallot.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Disclosures: Dr Goldstein has reported consulting relationships with Medtronic, W.L. Gore & Associates, and Edwards Lifesciences; and is an advisory board member for PECA Labs and Mezzion Pharma. Dr Qureshi has reported consulting relationships with W.L. Gore & Associates, Edwards Lifesciences, and Abiomed. Dr Zampi has reported consulting relationships with Medtronic and W.L. Gore & Associates. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

References

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