There have been many studies in our journal and others over the years regarding best ways to close a patent ductus arteriosus (PDA). But what if we just left the PDA alone to close by itself spontaneously? Would this be of benefit or harm to a very low birth weight (VLBW) infant? Semberova et al. ( 10.1542/peds.2016-4258) got to the heart of this matter by performing a retrospective cohort study in two neonatal intensive care units in Europe. The authors studied 368 VLBW infants of which 297 were free of congenital heart malformations and were discharged home. 280 were simply followed for their PDAs with serial echocardiography and of note, 85% of them had closed spontaneously prior to hospital discharge. What was associated with closure sooner than later? Were there any associated morbidities with not aggressively closing the PDA surgically prior to discharge?
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