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Intravenous prostaglandin E1 (alprostadil) bolus in ductus arteriosus-dependent CHD: valid or absolutely contraindicated?

Authors
  • Colín Ortiz, Jose L1
  • Cruz Hernández, Angel1
  • Silva Estrada, Jorge A1
  • Maldonado Alonso, Roberto2
  • Corona Villalobos, Carlos A1
  • González Rebeles Guerrero, Carlos1
  • Pérez Pérez, Linda F2
  • 1 Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico. , (Mexico)
  • 2 Department of Pediatric Cardiology, Hospital of the Poblano Child, Puebla, Mexico. , (Mexico)
Type
Published Article
Journal
Cardiology in the Young
Publisher
Cambridge University Press
Publication Date
Feb 01, 2024
Volume
34
Issue
2
Pages
314–318
Identifiers
DOI: 10.1017/S1047951123001403
PMID: 37403735
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The use of prostaglandin E1 is well documented in ductus arteriosus-dependent CHD or in neonatal pulmonary pathologies that cause severe pulmonary hypertension. The intravenous infusion is well established in loading infusion and maintenance with an onset of action of 30 minutes until 2 hours or even more. Our aim is to report three patients with pulmonary atresia that presented hypercyanotic spell due to a ductal spasm during cardiac catheterisation in whom the administration of a bolus of alprostadil reversed the spasm and increased pulmonary flow, immediately stabilising the condition of the patients allowing subsequent successful stent placement with no serious complications or sequelae after the administration of the bolus. More studies are needed to make a recommendation regarding the use of alprostadil in bolus in cases where the ductal spasm might jeopardise the life of the patient.

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