Use of beta-blockers in the post-operative period of Sano modification of the Norwood procedure with persistent cyanosis.
Persistent cyanosis is a frequent complication in the post-operative period of Sano modification of the Norwood procedure. It may be explained by a dynamic proximal shunt stenosis of the synthetic conduit that links the right ventricle to the pulmonary artery, as detected by echo cardiographic study. The use of beta-blockers in the post-operative period has been recently described in order to improve the arterial oxygen saturation. In this report, we describe the use of propranolol in two patients undergoing Sano modification of the Norwood procedure, in whom a gradient reduction in the synthetic conduit, increase in the levels of arterial oxygen saturation, decrease in heart rate, and increase in blood pressure were observed, thus resulting in clinical improvement. We conclude that the use of beta-blockers in these cases was beneficial.
Szwarc
Eli
E
Hospital do Coração, Associação do Sanatório Sírio, São Paulo, SP, Brazil. eli.med@terra.com.br
Rodrigues
Maria H S
MH
Pedra
Simone F
SF
Jatene
Marcelo B
MB
Romano
Edson R
ER
Ferreiro
Carlos R
CR
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D003490:Cyanosis / Q000188:drug therapy* / Q000209:etiology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D010101:Oxygen Consumption / Q000187:drug effects; D011184:Postoperative Period; D011433:Propranolol / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D011433:Propranolol