LONG-TERM EFFICIENCY OF HIGH-DOSE INOTROPIC SUPPORT IN AN INFANT AFTER REPAIR OF FALLOTS TETRALOGY

A 23 month old boy with highly symptomatic tetralogy of Fallot (TOF) u nderwent repair. Inspite of cold Bretschneider cardioplegic solution t wice the heart was beating soon after application of the cardioplegic solution each time. Soon after transfer to the intensive care unit the patient developed low cardiac output (LCO). The following days high d oses of inotropic support ware necessary to maintain sufficient arteri al pressure. The dosages of dobutamine (up to 49 mu g/kg/min); norepin ephrine (up to 5.28 mu g/kg/min, and epinephrine (up to 16 mu g/kg/min ), respectively, were twice and three times as high as common maximum recommendations. After having recovered from acute renal failure requi ring hemodialysis from the 5th to the 37th postoperative day the child was discharged 9 weeks after the intervention. The very unusual and i nteresting course of this boy is described and the form and grade of t he inotropic support is discussed.