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Duct dependant pulmonary perfusion

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I have a neonate with critical cyanotic heart disease on prostaglandin infusion

after that perfusion improved

Now the kid is hemodynamically stable

Cardiac CT confirms Pulmonary Atresia and double PDA supplying lungs

Shall we stop infusion?

What are all options available for the baby survival?

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Pulmonary atresia is with VSD or without ? Its a wide spectrum of disease so needs to do detailed echo and cath to know about PDA and major aorta-pulmonary shunts etc. also important to know about family history and any dysmorphism.

Coming back to your question -- prostaglandin must be continued until case is taken over by cardiology team and then they do palliative or complete repair. Palliative repair depends on kind of anatomy. If its a just atresia then could be perforated with cath and then ballon ... Else modified BT shunt.

Your baby responded to prostaglandin so very likely it is a duct dependent and not enough collaterals yet. So please do continue prostaglandin.

Survival again depends on complexity of anatomy and expert surgical facilities available.

Thanks for sharing your case and best wishes.

Dr Umar

Sent from my iPhone using Tapatalk

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