Transcatheter closure of patent ductus arteriosus in a tiniest baby – 510 grams

Transcatheter closure of patent ductus arteriosus (PDA) in low birth weight and extremely low birth weight (ELBW) infants has evolved as a less invasive alternative therapy to surgical ligation. In January 2019, the Amplatzer Piccolo PDA occluder was introduced as a new device specific for closure of the PDA in both low birth weight and ELBW infants. Although 700 g was determined the lowest weight for the use of this device in the clinical trial, it remains uncertain whether this device could be safely used in infants of weights <700 g. In this report, we describe successful closure of a large PDA in a 510 g critically ill ELBW infant using the Piccolo PDA occluder and address some of the unique challenges to device closure in this fragile population. To date, this appears to be the smallest infant recorded in whom transcatheter closure of the PDA was successfully performed.