Mustafa Orhan Bulut

Efficacy of very low-dose prostaglandin E1 in duct-dependent congenital heart disease.

AIM The present study aims to define the lowest effective prostaglandin E1 dose in patients with inadequacy of pulmonary blood flow and/or intracardiac blood mixing and those with inadequate systemic blood flow. METHODS Patients with inadequacy of both pulmonary blood flow and/or blood mixing (Group 1) and those with inadequate systemic blood flow (Group 2) were retrospectively evaluated in two separate groups with regard to the prostaglandin E1 starting dose given in the referring facility, the lowest and the highest dose administered in our centre, treatment duration, adverse effects, and administered treatment. RESULTS No difference between the groups could be detected with respect to sex or birth weight (p=0.95 and 0.42, respectively). Group 1 and Group 2 were statistically similar in aspect of prostaglandin treatment duration (9.73±0.81 days versus 11.6±1.05 days, p=0.064). When compared with Group 2, the initial, maintenance and lowest efficient doses of prostaglandin E1 treatment were significantly lower and the titrated dose of prostaglandin E1 was significantly higher in Group 1 (p=0.001 for each). CONCLUSION Our findings indicate that the infusion of prostaglandin at a very low dose (0.003-0.005 mcg/kg/minute) is sufficient to maintain the patency of the ductus arteriosus. A higher dose of prostaglandin E1 may be necessary in patients with inadequate systemic blood flow.

Stenting of the ductus arteriosus in infants with functionally univentricular heart disease and ductal-dependent pulmonary blood flow: A single-center experience

To determine the short‐ and medium‐term outcomes of ductal stenting (DS) in patients with functionally univentricular hearts (FUHs) and ductal‐dependent pulmonary blood flow.

Treatment of severe hemolysis following Nit-Occlud Lê VSD coil implantation with Amplatzer Duct Occluder II

Hemolysis after percutaneous device closure of ventricular septal defect (VSD) is a rare complication that can be conservatively managed in the majority of cases. However, surgery or transcatheter occlusion may be necessary. Presently described is the successful treatment of hemolysis that developed after implantation of the Nit-Occlud Lê VSD coil, using the Amplatzer Duct Occluder II (ADO II) in a patient with aneurysmatic perimembranous VSD. Systolic murmur and symptoms immediately disappeared after the procedure.