mukho wrote:
actually in almost all cyanotic heart diseases in newborns PDA is beneficial, which is why when in a newborn cyanotic heart disease is suspected, PGE2 is started even before definite type of CHD is confirmed by ECHO
True.  And if you ask me the disease in which PDA may be beneficial, I'd say TOF before TGA.
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| mukho
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hmm...hitesh, actually tetralogy is one of the few cyanotic hrt diseases that in fact doesnt require a PDA (unless the pulm stenosis part is actually an atresia)....so while if PDA is present, as it maybe, the cyanosis will be a bit less due to enhanced pulm flow, but cyanosis will still be there becoz primary reason for cyanosis is the vsd with ps resulting in rt to lt shunt at ventricular level...also pda may increase chances of CHF ...so i dont know if choosing TOF over TGA, which may NEED it for survival, is a better idea
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| hitesh
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DA is kept patent in babies with TOF esp when its severe and the child has low O2 levels at birth..Such patients need surgery in the neonatal period.. I said I'd pick TOF over TGA just cos its a lot more common (I think) ..lemme find a good source to quote here.. 
Edited by hitesh on 06/16/08 - 02:27 AM
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| mukho
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yes as i said PDA is maintained in TOF patients when it is critical which means the PS is close to atresia..and yes it is more common than TGA ...but i just felt that in most TOF cases PDA is not critical to survival unlike the condition in some other cyanotic heart diseases...
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| hitesh
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thats true
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| vaibhavbora
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good concept
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