Palliative treatment in dextro-transposition of the great arteries


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Palliative treatment
Critically ill newborns benefit from the infusion of Prostaglanding E1, which is used to prevent closure of the PDA (additional shunt) through which the systemic circulation is provided with a higher level of oxygen.

Balloon atrial septostomy, enlargement of the interatrial communication using a balloon, allowing better atrial-level mixing between the two parallel circulations. The catheter is introduced via femoral venous or umbilical venous approach, and passed into the right atrium, across the oval foramen and into the left atrium (LA) under echocardiographic or angiographic guidance. Once the ballon is in the LA, is inflated and drawned back across the oval foramen, producing a tear of the interatrial septum.

Antibiotics are often used because the patient is invaded with arterial and vein lines, nasogastric tube, urethral catheter, etc, that makes the patient very susceptible to infections.

Diuretics aid in flushing excess fluid from the body, thereby easing strain on the heart.

Cardiac glycosides, used to maintain proper heart rhythm while increasing the strength of each contraction.

Sedatives may be used palliatively to prevent a young child from pulling out any of their lines.

Acknowledgements and Initial Contributors to Page
Leida Perez, M.D.