Eight infants with cardiac malformations that were dependent on the patency of the ductus, were treated with Prostaglandin E 1 to reverse the closure of the duct. There was clinical improvement in 7 out of the 8 infants, confirmed by improvement in oxygen saturation and/or blood gases. In four cases the opening of the duct was visualised by angiography immediately after the prostaglandin infusion. Side-effects observed were transient pyrexia, flush reactions, apnoeic spells and one case of renal shock. Microscopic examination revealed in the four cases studied conspicuous edema of the media of the dictus. Because of the edema, the ductal wall is friable which indirectly may account for the severe lesions observed in the ductal wall. Prostaglandine E1 has a place in paediatric cardiology but in view of the observations made on the ductal wall it seems advisable to administer the drug only in a low dose and for a short duration.

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