{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:03:12Z","timestamp":1775552592325,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":96,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["24AA2006"],"award-info":[{"award-number":["24AA2006"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although surgery was traditionally the primary modality for definitive patent ductus arteriosus (PDA) closure, the indications for transcatheter closure have expanded with device advancements in recent decades. This study aimed to describe the trends in surgical and transcatheter closure for PDA in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged &lt;16\u2009years who underwent procedural PDA closure between April 2011 and March 2023 were identified from the Diagnosis Procedure Combination database in Japan. Considering the redaction of the requirements for the Amplatzer Duct Occluder (age \u22656\u2009months and weight \u22656\u2009kg) in 2016, patients were stratified by this erstwhile weight threshold (6\u2009kg) to evaluate the impact of this regulatory change. We analyzed data from consecutive 2\u2010year periods. We examined the trend in the proportion of transcatheter closure among all procedural PDA closures using multivariable mixed\u2010effects logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study enrolled 5638 patients (3235 weighing &lt;6\u2009kg and 2403 weighing \u22656\u2009kg). The proportion of transcatheter closure increased over time from 13\/466 (2.8%) patients in 2011\u20132012 to 60\/431 (13.9%) in 2021\u20132022 in patients weighing &lt;6\u2009kg (adjusted odds ratio 1.46, 95% confidence interval 1.29\u20131.67), and from 268\/316 (84.8%; 2011\u20132012) to 392\/416 (94.2%; 2021\u20132022) in patients weighing \u22656\u2009kg (1.56, 1.38\u20131.76).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the proportion of transcatheter closure steadily increased in patients weighing &lt;6\u2009kg, its implementation was slow and surgical closure remained the primary treatment. Transcatheter closure has become the predominant option for patients weighing \u22656\u2009kg.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70388","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:19:57Z","timestamp":1775549997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in procedural closure of patent ductus arteriosus among children from 2011 to 2022 in Japan"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2258-054X","authenticated-orcid":false,"given":"Kyosuke","family":"Ibi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2852-2946","authenticated-orcid":false,"given":"Yoshihisa","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Real\u2010World Evidence, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8804-8628","authenticated-orcid":false,"given":"Yuichiro","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-689X","authenticated-orcid":false,"given":"Ryo","family":"Inuzuka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Institute of Science Tokyo Graduate School  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-1774","authenticated-orcid":false,"given":"Motohiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-469X","authenticated-orcid":false,"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"138","article-title":"Patent ductus arteriosus: an overview","volume":"12","author":"Dice JE","year":"2007","journal-title":"J Pediatr Pharmacol Ther"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1161\/CIRCULATIONAHA.105.592063","article-title":"Patent ductus arteriosus","volume":"114","author":"Schneider DJ","year":"2006","journal-title":"Circulation"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.acvd.2014.01.008","article-title":"Transcatheter closure of patent ductus arteriosus: past, present and future","volume":"107","author":"Baruteau AE","year":"2014","journal-title":"Arch Cardiovasc Dis"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.025784","article-title":"Patent ductus arteriosus: a contemporary perspective for the pediatric and adult cardiac care provider","volume":"11","author":"Backes CH","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1161\/CIR.0b013e31821b1f10","article-title":"Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association","volume":"123","author":"Feltes TF","year":"2011","journal-title":"Circulation"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1053\/j.semperi.2011.09.025","article-title":"The patent ductus arteriosus in term infants, children, and adults","volume":"36","author":"Schneider DJ","year":"2012","journal-title":"Semin Perinatol"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.acvd.2009.04.006","article-title":"Advances in paediatric interventional cardiology since 2000","volume":"102","author":"Abadir S","year":"2009","journal-title":"Arch Cardiovasc Dis"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1038\/s41372-019-0506-7","article-title":"Patent ductus arteriosus in preterm infants: is early transcatheter closure a paradigm shift?","volume":"39","author":"Vali P","year":"2019","journal-title":"J Perinatol"},{"key":"e_1_2_11_10_1","article-title":"A global perspective on PDA management in the extremely premature: shifting trend toward transcatheter closure","volume":"2","author":"Sathanandam S","year":"2023","journal-title":"J Soc CardioVasc Angiogr Interv"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1017\/S1047951115001869","article-title":"Surgical ligation of patent ductus arteriosus in premature infants: trends and practice variation","volume":"26","author":"Weinberg JG","year":"2016","journal-title":"Cardiol Young"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2021-052874","article-title":"Variation of patent ductus arteriosus treatment in very low birth weight infants","volume":"148","author":"Runte KE","year":"2021","journal-title":"Pediatrics"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jpeds.2021.12.071","article-title":"International variation in the management of patent ductus arteriosus and its association with infant outcomes: a survey and linked cohort study","volume":"244","author":"Isayama T","year":"2022","journal-title":"J Pediatr"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1159\/000535121","article-title":"International online survey on the management of patent ductus arteriosus","volume":"121","author":"Woodford S","year":"2024","journal-title":"Neonatology"},{"key":"e_1_2_11_15_1","first-page":"1","article-title":"Guidelines for indications of catheter interventions for congenital and pediatric cardiac diseases","author":"Otsuki S","year":"2024","journal-title":"Jpn Soc Congen Interv Cardiol"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.37737\/ace.24015","article-title":"Updated information on the diagnosis procedure combination data","volume":"6","author":"Yasunaga H","year":"2024","journal-title":"Ann Clin Epidemiol"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1002\/ajmg.a.37104","article-title":"Medical procedures and outcomes of Japanese patients with trisomy 18 or trisomy 13: analysis of a nationwide administrative database of hospitalized patients","volume":"167","author":"Ishitsuka K","year":"2015","journal-title":"Am J Med Genet A"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40560-023-00652-9","article-title":"Descriptive statistics and risk factor analysis of children with community\u2010acquired septic shock","volume":"11","author":"Miura S","year":"2023","journal-title":"J Intensive Care"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.je.2016.09.009","article-title":"Validity of diagnoses, procedures, and laboratory data in Japanese administrative data","volume":"27","author":"Yamana H","year":"2017","journal-title":"J Epidemiol"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1007\/s00595-022-02521-8","article-title":"Validity of operative information in Japanese administrative data: a chart review\u2010based analysis of 1221 cases at a single institution","volume":"52","author":"Konishi T","year":"2022","journal-title":"Surg Today"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.1111\/ped.70178","article-title":"Validity of diagnoses, procedures, and birth records in a Japanese administrative claims database for pediatric patients","volume":"67","author":"Maki W","year":"2025","journal-title":"Pediatr Int"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2431-14-199","article-title":"Pediatric complex chronic conditions classification system version 2: updated for ICD\u201010 and complex medical technology dependence and transplantation","volume":"14","author":"Feudtner C","year":"2014","journal-title":"BMC Pediatr"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1002\/sim.7336","article-title":"Intermediate and advanced topics in multilevel logistic regression analysis","volume":"36","author":"Austin PC","year":"2017","journal-title":"Stat Med"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010025\u201003869\u20107"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpeds.2023.113716","article-title":"Trends in procedural closure of the patent ductus arteriosus among infants born at 22 to 30\u2009weeks' gestation","volume":"263","author":"Shah ZS","year":"2023","journal-title":"J Pediatr"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpeds.2023.113712","article-title":"Current trends in invasive closure of patent ductus arteriosus in very low birth weight infants in United States Children's Hospitals, 2016\u20132021","volume":"263","author":"Lai KC","year":"2023","journal-title":"J Pediatr"},{"key":"e_1_2_11_27_1","first-page":"1118","article-title":"Transcatheter closure of patent ductus arteriosus using the AMPLATZER\u2122 duct occluder II (ADO II)","volume":"89","author":"Gruenstein DH","year":"2017","journal-title":"Catheter Cardiovasc Interv"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1017\/S1047951123001385","article-title":"Piccolo in transcatheter PDA closure multi\u2010centre study from premature to adolescent children","volume":"34","author":"Baspinar O","year":"2024","journal-title":"Cardiol Young"},{"key":"e_1_2_11_29_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-2927","article-title":"Percutaneous patent ductus arteriosus (PDA) closure during infancy: a meta\u2010analysis","volume":"139","author":"Backes CH","year":"2017","journal-title":"Pediatrics"},{"key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1053\/j.semperi.2018.05.009","article-title":"Catheter\u2010based closure of the patent ductus arteriosus in lower weight infants","volume":"42","author":"Pavlek LR","year":"2018","journal-title":"Semin Perinatol"},{"key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1136\/heartjnl-2018-314428","article-title":"Trends in surgical and catheter interventions for isolated congenital shunt lesions in the UK and Ireland","volume":"105","author":"Farooqi M","year":"2019","journal-title":"Heart"},{"key":"e_1_2_11_32_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.022776","article-title":"Trend and outcomes for surgical versus transcatheter patent ductus arteriosus closure in neonates and infants at US Children's hospitals","volume":"11","author":"Kuntz MT","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_11_33_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2024-065905","article-title":"Transcatheter and surgical ductus arteriosus closure in very low birth weight infants: 2018\u20132022","volume":"154","author":"Leahy BF","year":"2024","journal-title":"Pediatrics"},{"key":"e_1_2_11_34_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpeds.2023.113877","article-title":"Secular trends in patent ductus arteriosus management in infants born preterm in the National Institute of Child Health and Human Development Neonatal Research Network","volume":"266","author":"Kaluarachchi DC","year":"2024","journal-title":"J Pediatr"},{"key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1038\/s41372-024-02052-9","article-title":"Procedural closure of the patent ductus arteriosus in preterm infants: a clinical practice guideline","volume":"44","author":"Mitra S","year":"2024","journal-title":"J Perinatol"},{"key":"e_1_2_11_36_1","article-title":"PICS\/AEPC\/APPCS\/CSANZ\/SCAI\/SOLACI: expert consensus statement on cardiac catheterization for pediatric patients and adults with congenital heart disease","volume":"3","author":"Holzer RJ","year":"2024","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"e_1_2_11_37_1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1017\/S1047951124000027","article-title":"Closing the gap between acceptable and ideal in catheterisation for paediatric and congenital heart disease \u2013 a global view","volume":"34","author":"Michel\u2010Behnke I","year":"2024","journal-title":"Cardiol Young"},{"key":"e_1_2_11_38_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2023.100344","article-title":"Congenital cardiac catheterization in low\u2010 and middle\u2010income countries: the International Quality Improvement Collaborative Catheterization Registry","volume":"2","author":"Ali F","year":"2023","journal-title":"JACC Adv"},{"key":"e_1_2_11_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2025.101649","article-title":"Comparative congenital cardiac catheterization registry analysis from the United States and low\u2010 and middle\u2010income countries","volume":"4","author":"Ali F","year":"2025","journal-title":"JACC Adv"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:20:05Z","timestamp":1775550005000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70388"],"URL":"https:\/\/doi.org\/10.1111\/ped.70388","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70388"}}