Prostaglandin E-2 bei cyanotischen Herzfehlern im Neugeborenenalter

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Abstract
14 newborn babies with pulmonary atresia (4) or transposition (TGA) (8) received Prostaglandin E2 infusions to correct their hypoxia and acidosis. 12 out of 10 patients were infused before diagnostic catheterization and creation of an interatrial communication by balloon atrioseptostomy. Infusions were stopped after septostomy in patients with transposition and prolonged up to palliative surgery in pulmonary atresia patients. All patients whose treatment was started in the first four days of life had a highly significant rise of their paO2. The only non-responder was a patient with TGA after septostomy who was a non-mixer and seven days old. Typical side effects of PGE2 were seen in two-thirds of all cases. One patient with TGA needed ductus ligation after PGE2 withdrawal because of congestive heart failure due to prolonged ductus patency. We conclude that prostaglandins of the E-type can safely be used in all cases of TGA with hypoxia and acidosis who are awaiting catheterization. Even when an adequate interatrial communication does not yet exist PGE2 seems to bring good oxygenation by opening the ductus. Used up to a maximum of 32 hours infusion-time heart failure was not seen.

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