In 1967, Porstmann performed the first successful non-open arterial ductus arteriosus (PDA) occlusion. In China, this technique was applied in 1983, and in 1977, Rashkind et al. successfully closed the PDA by delivering an umbrella patch through the venous route; in 1992, Cambier used a spring steel ring to seal the PDA; in 1997, Masura et al. started to use the Amplatzer blocker to treat the PDA; in China, the Amplatzer technique was introduced in 1998. Currently, the Amplatzer method and the spring bolus method are commonly used at home and abroad. The Amplatzer method is used for the treatment of PDA with left-to-right shunts that do not combine with cardiac malformations requiring surgery; the narrowest diameter of the PDA is ≥2 0mm; age: usually ≥6 months, weight ≥4kg. 2. post-surgical residual shunts. Tips:≥ 14mm PDA, its operation is difficult, the success rate is low, many complications, should be cautious. (B) spring embolus method 1. left-to-right shunt does not combine the PDA of cardiac malformations requiring surgery; PDA narrowest diameter (single Cook embolus ≤ 2 0mm; single pfm embolus ≤ 3mm). Age: usually ≥ 6 months, weight ≥ 4 kg. 2. post-surgical residual shunt. Contraindications (a) Amplatzer method 1. cardiac malformations dependent on the presence of PDA. 2. severe pulmonary hypertension and has led to right-to-left shunts. 3. sepsis, severe infection within 1 month before blocking surgery. (B) Spring embolization method 1. window type PDA. 2. the rest as above. Operation method (a) Preoperative preparation 1. electrocardiogram, X-ray chest film, echocardiogram. 2. relevant laboratory tests. (B) Diagnostic cardiac catheterization: puncture the femoral vein under local or general anesthesia for right heart catheterization; puncture the femoral artery for left-sided angiography of the descending aorta, measure the diameter of the PDA, and understand its morphology and location. (C) Procedure 1. Amplatzer method: Select a blocker with a diameter 2-4 mm larger than the narrowest diameter of the measured PDA (up to 6 mm in children), attach it to the tip of the delivery wire, and send it to the descending aorta along the delivery sheath under fluoroscopy. After the fixation disk of the blocker is fully opened, the delivery sheath and the delivery wire are retracted together to the aortic side of the PDA. If it is confirmed that the blocker is properly positioned and shaped, there is no or only a small residual shunt, and there is no heart murmur on auscultation, the blocker can be released by manipulating the rotating handle and the right heart catheterization can be repeated to measure the left pulmonary artery – main pulmonary artery and the ascending aorta – descending aorta. and ascending-descending aortic pressure. 2. spring embolus method 1) trans-femoral vein paracentesis: puncture the femoral vein to insert the end-hole catheter through the PDA into the descending aorta; select the appropriate diameter controllable spring embolus through the catheter into the descending aorta, place 3-4 turns on the aortic side of the PDA, 1 turn on the pulmonary side of the PDA. 10 min later repeat the aortic arch descending angiography, if it is confirmed that the location of the blocking spring embolus If the position and shape of the plug are satisfactory and there is no residual shunt, the spring plug can be released by manipulating the rotating handle. The right heart catheterization is repeated and the sheath is withdrawn to stop the bleeding. (2) Retrograde method via the femoral artery: puncture the femoral artery and insert an end-hole catheter through the PDA into the main pulmonary artery; select a controllable spring embolus of appropriate diameter and send it through the catheter into the pulmonary artery, placing 3/4 to 1 turn on the pulmonary side of the PDA and the remaining turns on the aortic side of the PDA. If the position and shape of the spring embolus are satisfactory, the spring embolus can be released by manipulating the rotating handle. 10 min later, the aortic arch descending angiography is repeated, and the catheter is withdrawn after success, and compression is applied to stop the bleeding. (Note: the operation should be strictly in accordance with the instructions for use of various products). If the blocker or spring embolus is properly positioned and there is no or only a slight to small amount of residual shunt, the result is good. V. Postoperative management1 Bed rest.2 Antibiotics.3 Echocardiography, electrocardiogram and chest X-ray should be repeated 24 hours, 1, 3, 6 and 12 months after the operation. Complications1 Complications of cardiac catheterization and angiography.2 Hemolysis.3 Dislodgement of the blocker.4 Stenosis of the left pulmonary artery and descending aorta.