Prostaglandin E1--bridge to cardiac transplantation: Technique, dosage, results

Abstract

We concluded that chronic infusions with prostaglandin E1 at reduced dosages is a feasible and safe therapeutic adjunct to bridge end-stage heart failure patients and may yield desirable effects in a subset of patients in the absence of inotropic support by dobutamine.

Nitric Oxide Versus Prostaglandin E1 for Reduction of Pulmonary Hypertension in Heart Transplant Candidates

“…Similar results have been obtained by others, 10,13 proving that PGE 1 infusion is effective at reducing pulmonary hypertension in patients with advanced heart failure. Hence, at many transplant centers, PGE 1 is an accepted standard approach for testing for the reversibility of pulmonary hypertension in heart transplant candidates.…”

Coronary Artery Bypass Surgery in Left Main Disease with Idiopathic Artery Pulmonary Hypertension. Role of PGE Therapy

“…Documented neuro-hormonal effects have been reported by Hulsmann, through a reduction of atrial natriuretic factor and norepinephrine on the one hand and increased renal blood flow, with increased diuresis [6][7][8][9][10].…”

Pulmonary Vasodilation in Acute and Chronic Heart Failure: Empiricism and Evidence

“…Prostaglandins safely lower PVR in most patients without causing significant side effects [35]. One case report and several small series described longer (ie, weeks) intravenous infusion of prostaglandins to "bridge" patients to heart transplant [36,37]. In patients with high PVR after cardiac surgery, inhaled prostacyclin decreased PVR by 29% and improved right ventricular performance [35].…”

“…During mitral valve surgery, inhaled iloprost was superior to intravenous nitroglycerin in preventing acute right ventricular failure during weaning from cardiopulmonary bypass [38]. Inhaled iloprost also was used as a short-term treatment of decompensated HF with favorable hemodynamic results [37,38].…”