Review of bedside ligation for patent ductus arteriosus in an extremely low birth weight infant

Patent ductus arteriosus (PDA) that fails to close after birth can lead to a hemodynamically significant left to right shunt, resulting in pulmonary overcirculation and systemic hypoperfusion. Currently, ligation performed in the operating room or at the bedside in the neonatal intensive care unit (NICU) are options for surgical treatment of hsPDA that has failed to close following pharmacological intervention, and bedside ligation is considered an optimized approach for preterm and extremely low birth weight (ELBW) infants. However, numerous challenges regarding the treatment of neonatal hsPDA via bedside ligation remain unsolved. Recently, a successful bedside PDA ligation has been performed in the NICU of Sichuan Provincial People's Hospital to treat an ELBW neonate with a gestational age of 27 + 1 weeks and a birth weight (BW) of 740 g. Echocardiography conducted 2 h after ligation revealed no distinct residual shunt at the great artery level. The infant's overall condition was favorable, and was successfully weaned from invasive mechanical ventilation on postoperative day 4. This article focuses on the diagnosis and comprehensive management of hsPDA in the presented case, synthesizing the findings with an extensive literature review to serve as a reference for managing such newborns with hsPDA.