Palliation of cyanotic congenital heart disease in infancy with E type prostaglandins

Abstract

Prostaglandin E (PGE) infusions have been used in an attempt to increase ductal patency in 11 infants aged 1 to 99 days with cyanotic heart disease. PGE1 was used in 9 infants and PGE2 in 2. Five patients had pulmonary atresia, 4 extreme pulmonary stenosis, 1 Ebstein's anomaly and 1 simple transposition of the great arteries. All but the oldest infant showed a satisfactory increase in oxygen saturation (average 36%) attributed to dilatation of the ductus. The failure in 1 infant may have been due largely to hypoplasia of the left pulmonary artery. The only important side effect was apnea in 1 infant receiving PGE2. The efficacy of this form of treatment is confirmed in infants dependent on ductal patency for survival. PGE is an important asset in saving the lives of neonates requiring an aorticopulmonary shunt operation. The recommended starting dose is 0.1 μg/kg/min of PGE 1 given by constant infusion.