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Ann Thorac Surg 1979;27:508-513
© 1979 The Society of Thoracic Surgeons

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Articles

The Use of Prostaglandin E₁ and Blalock-Taussig Shunts in Neonates with Cyanotic Congenital Heart Disease

From the Departments of Cardiothoracic Surgery, Pediatrics, and Anesthesiology, Fargo Clinic and St. Luke's Hospital, Fargo, and the University of North Dakota School of Medicine, Grand Forks, ND

Accepted for publication November 28, 1978.

^* Address reprint requests to Dr. Browdie, Fargo Clinic, 737 Broadway, Box 2067, Fargo, ND 58102

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 µg/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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