EFFECTS OF LEFT INTRAATRIAL INFUSION OF PROSTAGLANDIN E(1) AFTER OPEN-HEART-SURGERY

The hemodynamic effects of a left intraatrial infusion of prostaglandi n E(1) (PGE(1)) given to ten patients after open-heart surgery (LA gro up), were compared with those following no treatment in a control grou p of ten patients, and to those following a right intraatrial infusion given to another ten patients (RA group). PGE(1) was infused at a rat e of 0.03 mu g/kg/min in the RA group and at 0.003 mu g/kg/min in the LA group, and hemodynamics were measured immediately after surgery, th en 3, 6, and 12h after the PGE(1) infusion was commenced. The heart ra te, right atrial pressure, left atrial pressure, and mean pulmonary ar terial pressure remained almost unchanged in all three groups; however , the mean radial arterial pressure and systemic vascular resistance i ndex decreased, and the cardiac index increased in the RA and LA group s. The pulmonary vascular resistance index decreased only in the LA gr oup. Thus, a much smaller dose of PGE(1), being one-tenth of that used for the right atrial infusion, administered directly into the left at rium yielded almost the same hemodynamic effects as the larger dose in fused into the right atrium. Furthermore, this method of infusing PGE( 1) is safe, efficacious, and cost-efficient.