Open AccessMaintaining Patency of the Ductus Arteriosus for Palliation of Cyanotic Congenital Cardiac Malformations The Use of Prostaglandin E1 and Formaldehyde Infiltration of the Ductal Wall
Author(s) -
Joe Hatem,
Robert M. Sade,
Jane K. Upshur,
Arno R. Hohn
Publication year - 1980
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198007000-00022
Subject(s) - medicine , ductus arteriosus , prostaglandin e1 , surgery , pulmonary shunt , heart disease , shunt (medical) , hemodynamics , anastomosis , anesthesia , cardiology
We have used two methods to maintain ductal ppatency in 13 newborns during surgery for congenital cardiac malformations: prostaglandin E1 (PGE1) infusion for the short-term and formaldehyde infiltration of the ductus arteriosuos (FID) for the longer term. PGE1 increased the arterial oxygen saturation, leading to stable intraoperative hemodynamics in the six infants in whom it was used. FID was used in all 13 patients. Four of these patients died in the hospital, all with the ductus open. Of the nine early survivors, all required an additional shunt procedure. The five long-term survivors had the second palliative operation immediately, three hours, three days, two and one-half months, and four and one-half months after FID. We continue to use PGE1 to maintain ductal atency through operation, but use aortopulmonary anastomosis in the newborn period rather than FID.