Background Patent ductus arteriosus (PDA) results in pulmonary overcirculation and, depending on ductal size and patient age, may lead to symptoms of congestive heart failure and the development of pulmonary hypertension, among other complications. Percutaneous closure is currently considered the first-line option in most patients, depending on clinical and anatomical characteristics. Approved PDA occlusion devices are tailored to specific ductal morphologies; therefore, off-label devices such as muscular ventricular septal defect occluders, vascular plug II, or atrial septal defect occluders have been used in selected patients. With the advent of newer devices, and particularly the KONAR-MF™, a broad range of PDA morphologies can be treated, including in patients weighing 6 kg. Objectives To evaluate the clinical and epidemiological characteristics of patients in whom PDA was closed using the off-label KONAR-MF™ device and to report outcomes at 6 months postprocedure. Method This was a retrospective, single-center, descriptive observational case-series study with a 6-month follow-up. All patients who used the KONAR-MF™ device between 2024 and 2025 and met the inclusion and exclusion criteria were included in this study. Results Seventeen patients were analyzed. The median age was 1 year and the median weight was 11 kg. Female sex accounted for 58.8% of cases. Functional class III was present in 58.8% of patients. Severe pneumonia was the reason for admission in 23.5% of patients. Down syndrome was recorded in 17.6% of patients. According to the Krichenko classification, 47.1% of PDAs were type C, and 11.7% were associated with a ventricular septal defect. The median minimum ductal diameter was 5 mm and the median ductal length was 8 mm. The median pulmonary artery pressure was 25 mmHg, median fluoroscopy time was 9.7 min, and median radiation dose was 46 mGy/cm 2 . Transthoracic echocardiography combined with fluoroscopy was used in 11.8% of patients. The antegrade approach was used in 64.7% of procedures. The most frequently used device sizes were 6/4 and 12/10. On serial echocardiography, a residual shunt was detected in 23.5% of patients, and it had resolved in all of them by 6 months. Conclusion Despite the small sample size of this study, the findings suggest that the KONAR-MF™ device, when used off-label, may be a valid alternative in complex anatomies or in underweight patients.
Cabrera et al. (Mon,) studied this question.