Patent ductus arteriosus (PDA): Recent recommendations for to close or not to close

Ductus arteriosus which is a physiological necessity for intrauterine life, when is not capable of closing in the preterm infant due to the anatomical characteristics of the tissue, results in a number of hemodynamic alterations. Hemodynamically significant patent ductus arteriosus (hsPDA) is still an elusive condition that challenges neonatologists and pediatric cardiologists due to recent advances in the field of neonatology. The short- and long-term effects of hsPDA have been the focus of several research, reports, reviews, and meta-analyses. The current research question at new era is to treat PDA or not, and if to treat who is the target patient that may benefit from the treatment. Nowadays, more interoceptive approach among NICUs is rising depending on the outcomes of recently published studies concerning expectant management. Therefore, it would be best to make decisions about PDA management and follow-up on an individual basis, considering the balance of benefits and harms of both medical and surgical treatments. It is also essential to design scoring and prediction models to support these decisions and to identify patients who require and will benefit from treatment.