Long-term administration of prostaglandin E1: report of two cases with tetralogy of Fallot and esophageal atresia.

The authors continuously administered prostaglandin E1 (PGE1) iv to 2 infants with tetralogy of Fallot (TOF) and esophageal atresia with tracheoesophageal fistula (TEF) for more than 30 days, and observed side effects which could be attributed to the long-term administration of PGE1. After division of the TEF and anastomosis of the esophagus, leakage from the anastomosis developed in both cases. Because of the infectious foci in the thorax, Blalock's procedure was postponed and PGE1 was continued for 49 and 37 days. The authors believe radiographs of long bones and ribs demonstrated cortical hyperosteosis in both cases. Bone abnormalities became apparent approximately 30 days after the start of PGE1 and were associated with increases in serum alkaline phosphatase (peak value of about 2000 IU/L). Roentgenographic changes reverted toward normal and alkaline phosphatase values decreased after the cessation of PGE1 in both cases.