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

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.