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The Annals of Thoracic Surgery, Vol 27, 508-513, Copyright © 1979 by The Society of Thoracic Surgeons

ARTICLES

The use of prostaglandin E1 and Blalock-Taussig shunts in neonates with cyanotic congenital heart disease

DA Browdie, W Norberg, R Agnew, B Altenburg, R Ignacio and C Hamilton

Six unselected neonates with cyanotic congenital heart disease and life- threatening degrees of arterial oxygen desaturation have been managed by a protocol that includes administration of prostaglandin E1 (PGE1) and early Blalock-Taussig shunting. In 5 patients (seven paired observations) partial pressure of arterial oxygen (PaO2) rose from 19 mm Hg to a mean of 32.9 mm Hg within 20 minutes of initiation of PGE1 (0.1 to 0.2 microgram/kg/hr), infused intravenously or through an aortic catheter placed at ductal level or with both methods. The nonresponsive patient was older than the patients showing a positive response (1 month versus 24 to 96 hours). Following catheterization, immediate palliative operation including a Blalock-Taussig shunt was carried out. Although all had a satisfactory PaO2 (mean, 49 mm Hg) postoperatively, the PGE1-nonresponsive patient experienced serious intraoperative bradycardia, hypotension, and acidosis in contrast to the PGE1-responsive group. In this study, the use of PGE1 was not associated with any apparent serious side effects.




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Copyright © 1979 by The Society of Thoracic Surgeons.