title: Phentolamine as a treatment for poor mixing in transposition of the great arteries with adequate intraatrial communication.
abstract: 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.
authors.affiliation: 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
authors.forename: M O
authors.initials: MO
authors.lastname: Galal
authors.forename: W I
authors.initials: WI
authors.lastname: El-Naggar
authors.forename: M H
authors.initials: MH
authors.lastname: Sharfi
mesh_terms: 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
chemical_list: D000317:Adrenergic alpha-Antagonists; D010646:Phentolamine