[The effect of aldosterone antagonists in juvenile heart surgery]

In children with congenital heart disease duration and extent of hyperaldosteronism and the influence of spironolactone after surgery with a heart-lung-machine, were evaluated by direct measurement of plasma aldosterone levels. Secondary hyperaldosteronism as seen in 11 patients without spironolactone-therapy after surgery did not persist very long. 14 children receiving spironolactone immediately after surgery showed an onset of drug efficacy at a period when plasma aldosterone in the group without spironolactone had begun to fall. As a practical consequence, spironolactone treatment should be initiated a few days prior to surgery in order to achieve full efficacy on the day of surgery.