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Dr. Jonathan Flyer, pediatric and fetal cardiologist at the University of Vermont, presents findings from a Vermont Oxford Network analysis of over 11,000 extremely low birth weight infants examining whether the method of patent ductus arteriosus (PDA) closure — transcatheter device versus surgical ligation — makes a difference for neurodevelopmental outcomes at 18 to 24 months. The answer: no difference between the two techniques on Bayley-4 cognitive, language, and motor scores. The more sobering finding is that both groups scored well below the normative mean of 100, sitting in the high 70s to low 80s — a reminder of just how much ground this population has to cover. He also makes a case for centering the counseling conversation not on technique but on what each center does best, and what families actually care about most: their child's brain.

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