PGE 1 serves to reopen the ductus arteriosus or prevent it from closing. This allows partially desaturated systemic arterial blood to enter the pulmonary artery and be oxygenated. The widespread use of this agent has profoundly decreased early morbidity and mortality in patients with cyanotic heart defects. Patients can be stabilized more easily, allowing for safe transport to a tertiary care center. More time is also available for thorough diagnostic evaluation and patients can be brought to surgery in a more stable condition.
Adverse effects are relatively uncommon and include apnea, hypotension, edema, and low grade fever.
Various invasive catheterization procedures, already mentioned, may also be utilized early to stabilize patients with congenital heart disease. This technique is particularly useful in improving the arterial saturation of patients with transposition of the great arteries. Surgical Treatment Many infants with cyanotic heart disease will only survive with early surgical intervention. This is best approached by an experienced, multidisciplinary team which includes pediatric cardiac surgeons, cardiologists, anesthesiologists, intensivists, and skilled nursing personnel in a tertiary care setting. The timing and nature of each surgical procedure must be individualized to the specific cardiac malformation diagnosed, while taking the patient's overall condition into account.