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The sole Food and Drug Administration-approved device for transcatheter closure of the patent arterial duct in premature infants is indicated for patent ductus arteriosus (PDAs) ≤ 4 mm in diameter. We report a two-center experience with transcatheter closure of large PDAs (4 mm) in infants weighing 2.5 kg using the Microvascular Plug 7Q (MVP-7Q) device. This is a retrospective review of departmental databases and medical charts to define patient cohort and report demographic, procedural, and follow-up data. Twenty-two patients (12