<P> Neonates without adverse symptoms may simply be monitored as outpatients, while symptomatic PDA can be treated with both surgical and non-surgical methods . Surgically, the DA may be closed by ligation (though support in premature infants is mixed), either manually tied shut, or with intravascular coils or plugs that leads to formation of a thrombus in the DA . </P> <P> Devices developed by Franz Freudenthal block the blood vessel with woven structures of nitinol wire . </P> <P> Because prostaglandin E2 is responsible for keeping the DA open, NSAIDS (which can inhibit prostaglandin synthesis) such as indomethacin or a special form of ibuprofen have been used to initiate PDA closure . Recent findings from a systematic review concluded that, for closure of a PDA in preterm and / or low birth weight infants, ibuprofen is as effective as Indomethacin . It also causes fewer side effects (such as transient renal insufficiency) and reduces the risk of necrotising enterocolitis . A review and meta - analysis showed that paracetamol may be effective for closure of a PDA in preterm infants. . A recent network meta - analysis that compared indomethacin, paracetamol and ibuprofen at different doses and administration schemes among them found that a high dose of oral ibuprofen may offer the highest likelihood of closure in preterm infants . </P> <P> More recently, PDAs can be closed by percutaneous interventional method (avoiding open heart surgery). A platinum coil can be deployed via a catheter through the femoral vein or femoral artery, which induces thrombosis (coil embolization). Alternatively, a PDA occluder device, composed of nitinol mesh, is deployed from the pulmonary artery through the PDA . </P>

An abnormal opening between the pulmonary artery and the aorta caused by failure