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Oral sildenafil to control pulmonary hypertension after congenital heart surgery

Farah Peiravian1, Ahmad A Amirghofran, Mohammad Borzouee

  • 1Department of Pediatric Cardiac Surgery, Dena Hospital, Kazerun Islamic Azad University, Faculty of Medicine, Shiraz, Iran. fpeiravian@hotmail.com

Asian Cardiovascular & Thoracic Annals
|March 28, 2007
PubMed

Insights

Oral sildenafil effectively reduces pulmonary hypertension in children after congenital heart surgery. This treatment is safe, affordable, and prevents rebound pulmonary hypertension, offering significant benefits.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Congenital heart defects can lead to significant postoperative pulmonary hypertension.
  • Managing pulmonary artery pressure is critical for patient outcomes after complex heart surgeries.

Purpose of the Study:

  • To evaluate the efficacy and safety of oral sildenafil in reducing pulmonary artery pressure in children following congenital heart surgery.
  • To assess the impact of sildenafil on pulmonary hypertensive crises and rebound pulmonary hypertension.

Main Methods:

  • A comparative study involving postoperative children with congenital heart defects and pulmonary hypertension.
  • Administration of oral sildenafil (0.3 mg/kg every 3 hours for 24-48 hours) to the treatment group.
  • Comparison of pulmonary artery pressure and pulmonary artery to aortic pressure ratios between the sildenafil and control groups.

Main Results:

  • Significantly lower postoperative pulmonary artery pressure (28.61 +/- 7.80 vs 39.40 +/- 10.80 mm Hg) and PA/Ao pressure ratios (0.28 +/- 0.08 vs 0.41 +/- 0.11) in the sildenafil group (p < 0.001).
  • Absence of pulmonary hypertensive crises in the sildenafil group compared to 4 cases in the control group (p = 0.02).
  • No significant increase in pulmonary artery pressure upon drug discontinuation (p = 0.366) and no major complications observed.

Conclusions:

  • Low-dose oral sildenafil is effective and safe for controlling postoperative pulmonary artery pressure in pediatric patients.
  • Sildenafil offers advantages such as preventing rebound pulmonary hypertension, ready availability, and low cost.
  • The findings support the use of sildenafil as a valuable therapeutic option in managing post-congenital heart surgery pulmonary hypertension.

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