Right ventricular (RV) function immediately after left
ventricular assist device (LVAD) implantation is a crucial prognostic factor. RV failure is linked to increased mortality and worse outcome. A
phosphodiesterase 5 inhibitor,
sildenafil, was shown to decrease pulmonary vascular resistance and pulmonary artery pressure post-LVAD. We report on a series of
heart failure patients, and the effect of
sildenafil on the incidence of RV failure after LVAD implantation. We retrospectively analyzed the data of end-stage
heart failure patients who underwent LVAD implantation with
pulmonary hypertension and RV dysfunction prior to surgery. Patients were divided into two groups; group 1: patients who received
sildenafil perioperatively, and group 2: patients who did not receive
sildenafil. Hemodynamic and echographic data were collected before and after surgery. Fourteen patients were included, 8 patients in group 1 and 6 in group 2.
Sildenafil was administered with a mean dose of 56.2 ± 9.4 mg in group 1 and was able to significantly reduce right
heart failure incidence, and to demonstrate a significant reduction in pulmonary vascular resistance, pulmonary artery pressure, transpulmonary gradient, and a significant increase in cardiac output. In conclusion,
sildenafil seems to have a promising role perioperatively in preventing acute RV failure postsurgery in patients with RV dysfunction and
pulmonary hypertension, requiring LVAD
therapy.