**11. Conclusions**

The role of TCPC in ELBW infants will likely grow steadily, given the potential benefits of TCPC over other therapies. However, the most important question of "whether" the PDA needs to be closed at all still has to be answered. It is also prudent to determine "which" patients will benefit from closure, and in whom it is likely to close spontaneously. An RCT comparing TCPC vs. observation/conservative approach may be important to answer these questions. Hopefully, in the near future we will establish a treatment algorithm for ELBW with hsPDA.
