Despite patent ductus arteriosus closure in premature infants is a relatively fast procedure, it involves specific steps for equipment exchange and the use of a 4-Fr catheter, which may be large for tiny infants, potentially causing haemodynamic instability or tricuspid valve regurgitation.

This study aims to describe the early experience with a new technique designed to simplify transcatheter patent ductus arteriosus closure in premature infants. It enables the closure using the KA micro plug device via a single microcatheter without equipment exchanges and contrast exposure. This technique involves a simple modification of the microcatheter by creating a curved tip.

This is a retrospective, single-institution study involving premature infants who underwent attempted transcatheter patent ductus arteriosus closure using a manually modified microcatheter of the KA micro plug device at Stead Family Children’s Hospital.

Five patients underwent transcatheter patent ductus arteriosus closure using a KA micro plug with a modified microcatheter. The procedure was successful in all patients, with no haemodynamic instability. The median (range) for procedural weight, time, and radiation dose were 1055 g (730–1330), 12 minutes (11–19), and 0.49 µGy.m2 (0.14–1), respectively. At a median follow-up of 1.1 months (0.17–2.6), all patients maintained good device position without residual shunt or other concerning echocardiogram findings.

Transcatheter patent ductus arteriosus closure in infants weighing less than 1500 g can be successfully performed using a KA micro plug device through a microcatheter with zero-contrast use, low radiation exposure, and a short procedure time.

Transcatheter patent ductus arteriosus closure in premature infants is gaining attention with rapidly growing experience. The KA micro plug device poses many favourable features for ductus arteriosus closure in premature infants. The study aimed to describe the technique and outcomes of a KA micro plug in closing the ductus arteriosus in premature infants weighing less than 1500 g.

This is a single-centre retrospective study in premature infants with patent ductus arteriosus weighing less than 1500 g who underwent off-label use of a KA micro plug at the Stead Family Children’s Hospital from February 2022 to December 2023.

Eighteen premature infants weighing less than 1500 g underwent attempted transcatheter ductus arteriosus closure using a KA micro plug device. Median weight, age, and corrected gestational age at the procedure were 943 g (682–1225), 26 days (9–79), and 28.5 weeks (25.6–32), respectively. The procedure was successful with complete closure achieved in all patients. No major haemodynamic instabilities were encountered. No catheterization-related complications were encountered. On a median follow-up of 10.9 months (0.1–19), all patients are alive with the device in a good position without residual shunt or abnormal findings.

KA micro plug device for patent ductus arteriosus in infants weighing less than 1500 g is feasible, safe, and effective. We recommend that manufacturers of devices used to close the ductus arteriosus in small infants enhance both the devices and their delivery systems to simplify the procedure and mitigate the risk of haemodynamic instability.