Beitzke A, Suppan C H
Br Heart J. 1983 Apr;49(4):341-4. doi: 10.1136/hrt.49.4.341.
Fifteen infants with transposition of the great arteries and severe hypoxaemia were treated with prostaglandin E2 infusions before atrial septostomy was performed. Twelve patients had simple transposition and three had small ventricular septal defects. The infusion resulted in a highly significant increase of PaO2 from 22 +/- 3 mmHg to 37 +/- 5 mmHg within one to two hours. Only one patient did not respond to treatment. PaO2 remained constantly above 30 mmHg throughout prostaglandin infusion. After balloon atrial septostomy prostaglandin administration was stopped. Only two patients required reinfusion within 24 hours after septostomy because of a decrease of PaO2 below 25 mmHg. At angiocardiography before balloon septostomy the ductus was of aortic size in eight, and of about half the aortic diameter in six patients. In one infant the ductus was closed. One infant had to undergo early ductus ligation because of heart failure. In 10 of 11 infants who have undergone total correction the initially large ductus had closed spontaneously.
15例患有大动脉转位并伴有严重低氧血症的婴儿在进行房间隔造口术之前接受了前列腺素E2输注治疗。12例患者为单纯性大动脉转位，3例有小型室间隔缺损。输注导致动脉血氧分压（PaO2）在1至2小时内从22±3 mmHg显著升高至37±5 mmHg。只有1例患者对治疗无反应。在整个前列腺素输注过程中，PaO2持续保持在30 mmHg以上。球囊房间隔造口术后停止前列腺素给药。只有2例患者在造口术后24小时内由于PaO2降至25 mmHg以下而需要再次输注。在球囊造口术前的心血管造影检查中，8例患者的动脉导管直径与主动脉相同，6例患者的动脉导管直径约为主动脉直径的一半。1例婴儿的动脉导管已闭合。1例婴儿因心力衰竭不得不接受早期动脉导管结扎术。在接受完全矫正手术的11例婴儿中，有10例最初较大的动脉导管已自发闭合。
