Abstract | BACKGROUND: METHODS: Herein we have presented a series of 13 patients in whom sildenafil was used to treat right ventricular dysfunction and pulmonary hypertension as detected by transesophageal echocardiography and Swan-Ganz right heart catheterization after heart transplant. Their characteristics were mean age 49+/-11.4 years; 38.4% with previous cardiac procedures, 30.8% status I, basal pulmonary vascular resistance index 10.4+/-4.6 WoodU, mean transpulmonary gradient 18.7+/-5.4 mmHg. In addition to conventional inodilator support, we administered 1 to 3 mg per kilogram of sildenafil. Complete hemodynamic measurements were obtained before and after the institution of the therapy and at 1-month follow-up. RESULTS: Within the first 72 hours, acute right ventricular dysfunction resolved in all cases without untoward side effects or significant systemic impact. Sildenafil significantly decreased the transpulmonary gradient and pulmonary vascular resistance index relative to baseline values; 5.6+/-1.82 versus 10.4+/-4.6 WU, (P< .05), 13.5+/-3.4 mm Hg versus 18.7+/-5.4 mm Hg (P< .05), respectively. Improved indices of right ventricular function were observed on echocardiographic monitoring. After 1 month, sildenafil treatment was discontinued. CONCLUSION:
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Authors | L S De Santo, C Mastroianni, G Romano, C Amarelli, C Marra, C Maiello, N Galdieri, A Della Corte, M Cotrufo, G Caianiello |
Journal | Transplantation proceedings
(Transplant Proc)
2008 Jul-Aug
Vol. 40
Issue 6
Pg. 2015-8
ISSN: 0041-1345 [Print] United States |
PMID | 18675118
(Publication Type: Journal Article)
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Chemical References |
- Piperazines
- Purines
- Sulfones
- Vasodilator Agents
- Sildenafil Citrate
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Topics |
- Adult
- Cardiac Catheterization
- Child
- Echocardiography, Transesophageal
- Female
- Heart Transplantation
(adverse effects, mortality, physiology)
- Heart-Assist Devices
- Humans
- Hypertension, Pulmonary
(diagnostic imaging, drug therapy, etiology, physiopathology)
- Middle Aged
- Piperazines
(therapeutic use)
- Postoperative Complications
(drug therapy)
- Purines
(therapeutic use)
- Radiography
- Retrospective Studies
- Sildenafil Citrate
- Sulfones
(therapeutic use)
- Treatment Outcome
- Vascular Resistance
- Vasodilator Agents
(therapeutic use)
- Ventricular Dysfunction, Right
(drug therapy, etiology)
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