Phentolamine as a treatment for poor mixing in transposition of the great arteries with adequate intraatrial communication.
Patients with transposition of the great arteries often show poor mixing for different reasons, even after adequate balloon atrial septostomy. We present a patient with such a lesion whose clinical status improved dramatically after phentolamine was applied. We believe this improvement is due to reduction in afterload caused by the alpha(2) blocker and also possibly as a response to a presumptive effect of the drug on the diastolic function of the right ventricle, allowing more left-to-right shunt across the atrial septal defect. Both phenomena can improve cardiac output in such a situation.
Galal
M O
MO
Division of of Pediatric Cardiology, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, P.O. Box 40047, Jeddah 21499, Kingdom of Saudi Arabia. mogalal1@yahoo.de
El-Naggar
W I
WI
Sharfi
M H
MH
D000015:Abnormalities, Multiple; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D006348:Cardiac Surgical Procedures / Q000379:methods*; D018618:Echocardiography, Doppler, Color; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D010646:Phentolamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology
D000317:Adrenergic alpha-Antagonists; D010646:Phentolamine