Maintaining Patency of the Ductus Arteriosus for Palliation of Cyanotic Congenital Cardiac Malformations The Use of Prostaglandin E1 and Formaldehyde Infiltration of the Ductal Wall

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Abstract
Two methods were used to maintain ductal patency in 13 newborns during surgery for congenital cardiac malformations: prostaglandin E1 (PGE1) infusion for the short-term and formaldehyde infiltration of the ductus arteriosus (FID) for the longer term. PGE1 increased the arterial O2 saturation, leading to stable intraoperative hemodynamics in the 6 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. All 9 early survivors required an additional shunt procedure. The 5 long-term survivors had the 2nd palliative operation immediately, 3 h, 3 days, 2 1/2 mo. and 4 1/2 mo. after FID. PGE1 continues to be used to maintain ductal patency through operation, but aortopulmonary anastomosis is used in the newborn period rather than FID.