The use of oral sildenafil following corrective surgery for total anomalous pulmonary venous connection

Ali Sarıgül,

Ali Sarıgül¹, Ahmet Özkara¹, Cüneyt Narin¹, Gamze Sarkılar², Erdal Ege¹

¹Selçuk Üniversitesi Meram Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Konya
²Selçuk Üniversitesi Meram Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, Konya

A three-month-old girl underwent corrective surgery for total anomalous pulmonary venous connection. Despite nitroglycerin infusion, pulmonary hypertensive crises developed on the second postoperative day. Sildenafil citrate was administered through a nasogastric tube at a starting dose of 0.5 mg/kg/24 h by stepwise increments to a maximum dose of 2 mg/kg/24 h. Sildenafil lowered pulmonary arterial pressure and the patient was successfully weaned from mechanical respiratory support without any pulmonary hypertensive crises. The dramatic relief of a complicated postoperative course showed indirectly that the decrease in pulmonary pressure was sufficient. No adverse effects were seen associated with sildenafil administration. Oral sildenafil is a safe and potent adjunct to the existing therapies for postoperative pulmonary hypertension in infants undergoing open heart surgery.

Keywords : Cardiovascular surgical procedures; hypertension, pulmonary/ prevention & control; infant; phosphodiesterase inhibitors/ therapeutic use; pulmonary veins/abnormalities; sildenafil

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