In the management of TAPVR, what is crucial to keep the ductus arteriosus open?

Keeping the ductus arteriosus open is vital in managing Total Anomalous Pulmonary Venous Return (TAPVR). In this condition, the pulmonary veins drain abnormally into the right atrium or the systemic venous system, rather than directly into the left atrium. This creates significant problems with blood flow and oxygenation, especially in the neonatal phase. Prostaglandin E (PGE) plays a critical role in maintaining patency of the ductus arteriosus.

When the ductus arteriosus remains open, it allows for proper mixing of oxygenated and deoxygenated blood, which is essential for ensuring adequate systemic oxygenation in these patients. The use of PGE is especially important when anatomical defects such as TAPVR are present, because it helps to facilitate adequate blood flow to the systemic circulation until surgical correction can be performed.

In contrast to prostaglandin E, options such as oxygen administration, aspirin, and diuretics do not specifically address the need for ductal patency and therefore would not adequately fulfill this critical requirement in the management of TAPVR. Oxygen may improve oxygen saturation but does not directly affect the ductus arteriosus, aspirin is typically used for other vascular purposes and does not