Effects of left intraatrial infusion of prostaglandin E1 after open-heart surgery

The hemodynamic effects of a left intraatrial infusion of prostaglandin E1 (PGE1) given to ten patients after open-heart surgery (LA group), were compared with those following no treatment in a control group of ten patients, and to those following a right intraatrial infusion given to another ten patients (RA group). PGE1 was infused at a rate of 0.03 microgram/kg/min in the RA group and at 0.003 microgram/kg/min in the LA group, and hemodynamics were measured immediately after surgery, then 3, 6, and 12 h after the PGE1 infusion was commenced. The heart rate, right atrial pressure, left atrial pressure, and mean pulmonary arterial pressure remained almost unchanged in all three groups; however, the mean radial arterial pressure and systemic vascular resistance index decreased, and the cardiac index increased in the RA and LA groups. The pulmonary vascular resistance index decreased only in the LA group. Thus, a much smaller dose of PGE1, being one-tenth of that used for the right atrial infusion, administered directly into the left atrium yielded almost the same hemodynamic effects as the larger dose infused into the right atrium. Furthermore, this method of infusing PGE1 is safe, efficacious, and cost-efficient.