The preterm patent ductus arteriosus: the controversy of closure

Management of preterm patent ductus arteriosus (PDA) has, and currently is, an issue of much contention. Management strategies have varied between conservative medical management to pragmatic PDA surgical ligation. However, despite the association between the haemodynamically significant ductus arteriosus and many of the morbidities of the preterm neonate, there remains no clear benefit in morbidity and mortality to closure. This case demonstrates the challenges faced by both the neonatal and the cardiology teams and the common trajectory for the preterm infant with the haemodynamically significant patent ductus arteriosus. The case highlights up-to-date developing techniques, clinical tips, and important learning points to aid the management of this common, but controversial, pathology.