Congenital heart disease: Prostaglandin treatment
A decrease in prostaglandin E2 (PGE2) , along with exposure to oxygenated blood, causes the ductus arteriosus to close after birth .
Several prostaglandins have been used via the inhaled route, with the hope of attenuating some of the systemic hypotension – prostaglandins which have been tried include PGE1, PGI2 (prostacyclin, aka epoprostenol/Flolan), and a stable analog of PGI2 (iloprost/Ventavis). Milrinone, NTG, NTP have also been used in the inhaled form. That said, the efficacy of any of these inhaled regimens has not been firmly established.
Prostaglandins in Congenital Heart Surgery
- PGE1: maintains ductus patency at 0.1 ug/kg/min. Can diagnose duct-dependent lesion (see Hallidie-Smith KA, below)
- PGE2: maintains ductus patency at in utero (PGE2 not available as a drug)
- PGI2: epoprostenol/Flolan
- PGI2 Analog: iliprost/Ventavis