Congenital heart disease: Prostaglandin treatment

Pediatrics

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

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2010

Year asked