Przewodozależne wrodzone wady serca

Agnieszka Tomik, Jacek Skiendzielewski, *Bożena Werner

Summary
In duct-dependent congenital heart diseases a newborn is able to survive until the ductus arteriosus remains open. Duct-dependent cardiac lesions can be divided into three subgroups: duct-dependent blood mixing (e.g. transposition of the great arteries), duct-dependent pulmonary blood flow (e.g. pulmonary atresia, critical pulmonary stenosis, critical tetralogy of Fallot) and duct-dependent systemic blood flow (e.g. preductal coarctation of the aorta, critical aortic stenosis, hypoplastic left heart syndrome). The treatment with Prostaglandin E1 significantly improved prognosis in newborns with duct-dependent anomalies. Prostaglandin E1 maintains the ductus arteriosus patency by relaxing its smooth muscle. During Prostaglandin E1 infusion numerous side effects can occur: fever, respiratory distress, bradycardia or tachycardia, diarrhea, exacerbation of the intracranial hemorrhage, leukocytosis, hyperkalemia, obstruction of gastric cardia. This is why the treatment with Prostaglandin E1 requires constant monitoring of the newborn. In every newborn with suspected duct-dependent congenital heart disease (based on central cyanosis and/or heart failure) Prostaglandin E1 should be immediately started in neonatal departement. This procedure helps to keep hemodynamic stability until the final diagnosis and the qualification for surgery. The prognosis and the quality of life of children with these congenital heart diseases improved substantially with the progress of the operational techniques and innovative methods of interventional cardiology.

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