Expert consensus on bedside transcatheter closure of patent ductus arteriosus in extremely low birth weight infants.

Abstract

Transcatheter closure is becoming the standard of care for definitive closure of patent ductus arteriosus (PDA) in premature infants. To avoid risks associated with the transportation of a fragile neonate, the intervention can be performed as a bedside procedure within the neonatal intensive care unit, even in extremely low birth weight (ELBW) infants. Limited evidence-based guidelines are available for transcatheter PDA closure in premature infants in general and for bedside PDA closure specifically. This framework represents an expert consensus regarding bedside PDA closure in ELBW infants and guidance for procedural implementation. Recommendations for patient eligibility, pre-procedural planning, staff requirements, procedural aspects, imaging and follow-up and a stepwise implementation plan for a bedside PDA closure program are presented. IMPACT: Extremely low birth weight (ELBW) infants with a patent ductus arteriosus (PDA) may be considered for transcatheter PDA closure. An expert consensus is provided on bedside transcatheter PDA closure performed within the neonatology intensive care unit, thereby mitigating the risks associated with transportation of these highly vulnerable infants outside of the neonatology intensive care unit. Guidance is provided regarding procedural aspects, including staff requirements, planning, setting, and imaging, and implementation of a bedside transcatheter PDA closure program.