A Discourse on Percutaneous Closure of the Patent Ductus Arteriosus in Premature Neonates: Controversy, Remedy, or Paradox of Choice?

Whether conversations about the patent ductus arteriosus (PDA) are engaging and productive or controversial and inconclusive, they are commonplace within the neonatal intensive care unit. “To close or not to close” is often the final question that concludes these conversations. Even in the era when surgical closure was the only option for intervention, a consensus on the best management was typically difficult to achieve. The development and widespread adoption of percutaneous PDA closure in premature neonates has now added a new dimension to these conversations and converted the binary question to a more nuanced process that incorporates less invasive options. Because the procedure has been well established and shown to be safe in appropriately selected babies, it is timely to consider what, if any, aspects of the decision-making process have changed in the premature neonate. This article is a comprehensive review of the current literature on the minimally invasive transcatheter PDA closure procedure in premature babies and aims to examine the impact of this procedure on clinical decision-making in neonatology practice.