What is the optimal device for closure of a persistently patent ductus arteriosus?

Transcatheter closure of persistently patent ductus arteriosus (PDA) has been performed since the early 1990s. Over the past 15 years, there have been significant developments in the devices used to close PDA. The currently available devices in the United States that are or will soon be approved for PDA closure are: embolization coils, Amplatzer Duct Occluders I/II, and the Product For Medicine Nit-Occlud devices. Each device has its strengths and limitations. Three criteria will be used to determine which device is superior to close PDA. Safety, including the occurrence of hemolysis, pulmonary artery and/or aortic obstruction, vascular complications, and frequency of device embolization will be evaluated for each device. Efficacy will be determined at 6 month echo follow-up regarding residual shunt. Finally, overall cost will be considered. After evaluating each device on these merits, we will conclude which device, if any, is superior for closure of PDA.