Heymann M A, Berman W, Rudolph A M, Whitman V
Circulation. 1979 Jan;59(1):169-73. doi: 10.1161/01.cir.59.1.169.
Infants with aortic arch interruption of juxtaductal coarctation of the aorta may depend on patency of the ductus arteriosus to provide adequate lower body perfusion. In many such infants the ductus arteriosus constricts after birth, resulting in severe heart failure, poor systemic perfusion and acidemia. We infused prostaglandin E1 (PGE1) at a rate of 0.05--0.1 microgram/kg/min into seven infants with aortic arch interruption and eight infants with coarctation. In one infant in each group the ductus arteriosus was already closed and did not reopen. In one infant with coarctation an adequate trial was not accomplished, and in another adequate pressure measurements were not obtained. Of the remaining 11, the ductus arteriosus was effectively dilated by PGE1 in 10 infants. This was evidenced by an increase in descending aortic blood pressures and a reduction in the pressure difference between the main pulmonary artery and descending aorta in six infants with aortic arch interruption and between ascending and descending aorta in four infants with coarctation. Lower body perfusion improved and left ventricular failure was improved. The infant who did not respond was 5 months old. There were no complications.
患有主动脉弓中断或主动脉导管旁缩窄的婴儿可能依赖动脉导管的通畅来提供足够的下半身灌注。在许多此类婴儿中，动脉导管在出生后会收缩，导致严重心力衰竭、全身灌注不良和酸血症。我们以0.05 - 0.1微克/千克/分钟的速率向7名患有主动脉弓中断的婴儿和8名患有缩窄的婴儿输注前列腺素E1（PGE1）。每组中有一名婴儿的动脉导管已经闭合且未重新开放。在一名患有缩窄的婴儿中，未完成充分的试验，在另一名婴儿中未获得充分的压力测量值。在其余11名婴儿中，10名婴儿的动脉导管被PGE1有效扩张。这在6名患有主动脉弓中断的婴儿中表现为降主动脉血压升高以及主肺动脉与降主动脉之间的压差减小，在4名患有缩窄的婴儿中表现为升主动脉与降主动脉之间的压差减小。下半身灌注得到改善，左心室衰竭也得到改善。没有反应的婴儿为5个月大。没有并发症。
