Key result
PDA closure in infants resolves pulmonary hypertension, leaving persistent PH in under ~1% at 1 year.
Why the study?
The management of patent ductus arteriosus in infants with pulmonary hypertension remains controversial due to concerns regarding irreversible pulmonary vascular disease and post-closure hemodynamic deterioration, and evidence in children <12 months is limited.
What are the hemodynamic profiles, clinical outcomes, and rates of persistent pulmonary hypertension following ductal closure in infants under 12 months of age with isolated PDA and pulmonary hypertension?
Cohort (n=220)
No
What are the hemodynamic profiles, clinical outcomes, and rates of persistent pulmonary hypertension following ductal closure in infants under 12 months of age with isolated PDA and pulmonary hypertension?
In infants <12 months with isolated PDA and pulmonary hypertension, ductal closure results in near-universal normalization of pulmonary pressures, with persistent PH restricted to those with developmental lung disease or severe syndromic comorbidities.
Answers are grounded in this paper and cite their sources.
Supports PDA closure for PH resolution in infants without major comorbidities; leaves open whether routine catheterization improves risk stratification in broader populations.
Background: The management of patent ductus arteriosus (PDA) in infants with pulmonary hypertension (PH) remains controversial due to concerns regarding irreversible pulmonary vascular disease and post-closure hemodynamic deterioration. Evidence in children <12 months is limited. We aim to describe the hemodynamics and outcomes of infants with isolated PDA and PH undergoing invasive evaluation and to identify clinical factors associated with PH persistence after closure. Methods: We retrospectively analyzed infants <12-months with isolated PDA and mean pulmonary artery pressure (mPAP) > 20 mmHg who underwent right heart catheterization. Hemodynamics, procedural strategy, and clinical outcomes were assessed at 6-/12-months, and last follow-up. Results: A total of 220 patients were included (mean age 154 ± 87 days; weight 5.7 ± 1.7 kg). mPAP was 36.5 ± 12.8 mmHg and Qp/Qs 1.9 ± 1.0. PDA closure was performed in 214 patients (186 transcatheter, 28 surgical). Cumulative mortality was 1.8%, occurring exclusively in patients with severe comorbidities. Persistent PH was noted in 8 patients (3.6%) at 6-months and 2 patients (0.9%) at 12-months and long-term follow-up. No cases of PH relapse were observed after successful closure. All persistent PH cases were associated with developmental lung disease or severe syndromic conditions. Infants without major comorbidity demonstrated resolution of PH after closure. Conclusions: In infants with isolated PDA and PH, ductal closure within the 1 year is associated with near-universal normalization of pulmonary pressures. Persistent PH is uncommon and primarily confined to patients with developmental lung disease. Clinical and echocardiographic assessment combined with invasive hemodynamic should guide operability decisions.
No takes yet. Share an insight, caveat, or question.
Callegari et al. (2026) conducted a cohort in Isolated patent ductus arteriosus (PDA) with pulmonary hypertension (PH) (n=220). PDA closure (transcatheter in 186 patients, surgical ligation in 28 patients) was evaluated on Persistence of pulmonary hypertension at 6 months, 12 months, and long-term follow-up. PDA closure in infants <12 months with pulmonary hypertension resulted in resolution of PH in all patients without major comorbidities, with persistent PH in only 3.6% at 6 months and 0.9% at 12 months.
Synapse has enriched 10 related papers. Consider them for comparative context: