HLHS management includes maintaining ductus arteriosus patency with which therapy?

HLHS management includes maintaining ductus arteriosus patency with which therapy?

• A. Sub-Ambient FiO2
• B. Prostaglandins
• C. Hypercarbic Gas
• D. Surgical Repair

Answer: (B)

In HLHS, the systemic circulation relies on the ductus arteriosus to stay open because the left-sided structures can’t provide adequate flow after birth. Keeping the ductus patent allows blood from the right ventricle to reach the aorta and sustain systemic perfusion until staged palliation is completed. Prostaglandin E1 (alprostadil) is given as a continuous IV infusion to relax the smooth muscle of the ductus arteriosus, preventing its closure. Other options don’t achieve this effect. Reducing FiO2 doesn’t reliably keep the ductus open and can have harmful effects; higher CO2 levels aren’t used as a controlled method to maintain patency; and surgical repair would close the ductus as part of the palliation process, not keep it open.

In HLHS, the systemic circulation relies on the ductus arteriosus to stay open because the left-sided structures can’t provide adequate flow after birth. Keeping the ductus patent allows blood from the right ventricle to reach the aorta and sustain systemic perfusion until staged palliation is completed. Prostaglandin E1 (alprostadil) is given as a continuous IV infusion to relax the smooth muscle of the ductus arteriosus, preventing its closure.

Other options don’t achieve this effect. Reducing FiO2 doesn’t reliably keep the ductus open and can have harmful effects; higher CO2 levels aren’t used as a controlled method to maintain patency; and surgical repair would close the ductus as part of the palliation process, not keep it open.