Alpha blocker and angiotensin-converting enzyme inhibitor in the management of severe pulmonary valve stenosis: from bench to bedside

What is it about?

In a case series of 20 neonates it could be shown that alpha blocker as well as ACE-I have a role in the management of critical pulmonary valve stenosis, even after successful balloon dilation. These 20 neonates out of a series of 28, remained oxygen dependent after balloon dilation. The neonates were started on either alpha blocker or ACE-I. 19 / 20 responded positively to this management and could be discharged home earlier than historical series. The one patient in whom this management had no effect developed significant infundiblar stenosis after balloon dilation. We believe that both drugs improve right ventricular compliance reducing the obligatory right to left shunt atrial level in critical pulmonary valve stenosis.

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Why is it important?

The use of this new therapeutic management could reduce the length of hospital stay significantly. Usually some of these patients will need 2-3 weeks of hospitalization until the right ventricular compliance improves.