OPEN OR SHUT CASE?

Despite much meticulous research we are essentially still in the dark on what to do about the patent ductus arteriosus in preterm infants. Should the medical treatment approach be prophylactic, symptomatic, or haemodynamic? Should surgical closure take place early, late, or not at all? Brooks et al describe their experience where duct surgery is not available and suggest that the time has come for trials to determine whether surgical closure after failed medical treatment confers any benefit at all. In a perspective on the subject, Fowlie reminds us that there is no evidence that any treatment of patent ductus arteriosus results in long term benefit and repeats the call for further definitive …