Transcatheter Patent Ductus Arteriosus Closure in Extremely Premature Infants: Transition to the Bedside
In brief
Bedside PDA closure succeeded in all 176 extremely premature infants
In a 500-infant retrospective series, bedside closure succeeded in all 176 infants treated in the neonatal intensive care unit, with major complications in 1.7%, similar to lab-based procedures. Bedside procedures were shorter and used less radiation; long-term follow-up found no residual defects, but whether other NICUs can reproduce these results remains unknown.
- Journal
- JACC. Cardiovascular interventions (Q1)
- Published
- 28 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Shyam Sathanandam, Ashley Molloy, Ranjit Philip, Janet Sessums, Neil Tailor, Leah Apalodimas, et al.
- PMID
- 42805720
- DOI
- 10.1016/j.jcin.2026.05.040
Why clinicians should know about it
- Picked for Neonatology (paper of the day, 29 September 2026): Bedside TCPC feasible, safe for extreme preterms
Abstract
BACKGROUND: Extremely premature infants (<28 weeks' gestation) with hemodynamically significant patent ductus arteriosus (PDA) may require transcatheter PDA closure (TCPC) when medical therapy fails. Although TCPC is associated with improved respiratory outcomes over surgical ligation, its availability is limited because of the need to transport these critically ill infants to cardiac catheterization laboratories, delaying care and increasing risk. OBJECTIVES: The authors describe the successful transition of TCPC from the catheterization laboratory to the neonatal intensive care unit (NICU) bedside, emphasizing feasibility, safety, and early outcomes. METHODS: The authors conducted a retrospective review of infants at <28 weeks' gestation weighing <2 kg who underwent TCPC between July 2012 and December 2024. The program evolved in 3 phases: traditional laboratory-based TCPC (2012-2021), laboratory-based TCPC using transthoracic echocardiographic guidance only (July to December 2021), and bedside TCPC in the NICU (2022-2024). RESULTS: Of 500 infants, 176 underwent bedside TCPC. These infants were younger (median 20 days vs 29 days) and smaller (820 g vs 1,010 g) than laboratory-treated infants. Bedside procedures were shorter (18 minutes vs 32 minutes) and had reduced radiation exposure (0.019 Gy × cm2 vs 0.068 Gy × cm2; P < 0.001). Procedural success was 100% across all settings. Major complication rates were low (1.7%) and similar across settings. Follow-up (median 6.8 years) showed an 89% survival rate, no residual PDAs, and minimal late complications. CONCLUSIONS: Bedside TCPC is a feasible, safe, and effective approach for managing PDA in extremely premature infants. It eliminates the need for interhospital transport, supports earlier intervention, and may improve outcomes. With appropriate training and experience, bedside TCPC has the potential to become the standard of care across NICUs.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.