Regan E. Giesinger1, Adrianne R. Bischoff3, Patrick J. McNamara1,2
Congenital Heart Disease, Vol.14, No.2, pp. 311-316, 2019, DOI:10.1111/chd.12738
Abstract Ligation of a hemodynamically significant ductus arteriosus results in significant
changes in loading conditions which have predictable consequences. Postligation
cardiac syndrome, defined as hypotension requiring inotropic support and failure of
oxygenation and ventilation, may occur 6‐12 hours following ligation due to left ven‐
tricular systolic and diastolic failure, respectively. Afterload is the primary driver of
this decompensation. In this review, we describe the pathophysiological changes in
loading conditions associated with postligation cardiac syndrome and other contrib‐
utors to cardiovascular dysfunction following ductal ligation. We present strategies
for perioperative optimization and a physiology‐based algorithm for postoperative
management guided by targeted neonatal… More >
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