The first surgery for a congenital heart defect was a PDA ligation by Dr. Robert Gross (as a Chief Surgical Resident) in 1938 at Children’s Hospital Boston. Since that time, therapy for PDAs has changed considerably. Catheter-directed therapy for PDA has gradually evolved since its introduction by Porstmann in 1967. In March 1992, Cambier and Moore reported an innovative adaptation in the use of Gianturco steel coils when they occluded small (<2.5 mm) PDAs in four patients. This adaptation had major advantages over previous devices in that it employed existing catheter technology, obviating the need for regulatory review and licensing. The coils were inexpensive ($20–$25 each) and could be delivered through a venous or an arterial catheter using much smaller (4 Fr) introducing sheaths. In 2003, the amplatzer duct occluder was the first FDA-approved device for PDA closure.