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

Published online by Cambridge University Press:  05 July 2023

Jose L. Colín Ortiz Open the ORCID record for Jose L. Colín Ortiz [Opens in a new window] ,
Angel Cruz Hernández Open the ORCID record for Angel Cruz Hernández [Opens in a new window] ,
Jorge A. Silva Estrada Open the ORCID record for Jorge A. Silva Estrada [Opens in a new window] ,
Roberto Maldonado Alonso ,
Carlos A. Corona Villalobos ,
Carlos González Rebeles Guerrero  and
Linda F. Pérez Pérez
Jose L. Colín Ortiz*
Affiliation:
Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico
Angel Cruz Hernández
Affiliation:
Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico
Jorge A. Silva Estrada
Affiliation:
Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico
Roberto Maldonado Alonso
Affiliation:
Department of Pediatric Cardiology, Hospital of the Poblano Child, Puebla, Mexico
Carlos A. Corona Villalobos
Affiliation:
Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico
Carlos González Rebeles Guerrero
Affiliation:
Department of Paediatric Cardiology, National Institute of Paediatrics, Coyoacan, Mexico City, Mexico
Linda F. Pérez Pérez
Affiliation:
Department of Pediatric Cardiology, Hospital of the Poblano Child, Puebla, Mexico
*
Corresponding author: J. L. Colín Ortiz; Email: colin_jldgo@yahoo.com.mx
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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.

Keywords

Prostaglandin E1alprostadilductal spasmhypercyanotic spell
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 2 , February 2024 , pp. 314 - 318
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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