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Updated: Jul 15, 2026

Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension
09:23

Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension

Published on: February 11, 2017

Oral sildenafil ameliorates impaired pulmonary circulation early after bidirectional cavopulmonary shunt

Shintaro Nemoto1, Eitaro Umehara, Tadashi Ikeda

  • 1Department of Cardiovascular Surgery, Kyoto University Hospital, Kyoto University, Graduate School of Medicine, Kyoto, Japan. snemoto@poh.osaka-med.ac.jp

The Annals of Thoracic Surgery
|April 28, 2007
PubMed

Insights

Oral sildenafil effectively treated impaired pulmonary circulation in an infant after heart surgery. This phosphodiesterase-5 inhibitor improved oxygen saturation and normalized pulmonary pressure gradients, offering a potential new therapy.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Impaired pulmonary circulation and early clinical deterioration can occur post-bicavopulmonary shunt surgery.
  • Inhaled nitric oxide initially normalized pulmonary circulation but was insufficient after discontinuation.

Observation:

  • An infant experienced worsening pulmonary hypertension and oxygen desaturation after extubation and cessation of inhaled nitric oxide.
  • Administration of oral sildenafil was initiated in a stepwise manner.

Findings:

  • Oral sildenafil successfully normalized the transpulmonary pressure gradient.
  • Improved oxygen saturation was observed with sildenafil treatment.
  • Intravenous vasodilators were successfully discontinued during sildenafil therapy.

Implications:

  • Oral sildenafil demonstrates potential as an effective adjunctive therapy for managing postoperative pulmonary circulation issues.
  • This approach may offer a viable alternative or supplement to existing treatments for infants undergoing complex cardiac surgeries.
  • Further research into sildenafil's role in pediatric cardiovascular surgery is warranted.

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