ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The use of oral sildenafil following corrective surgery for total anomalous pulmonary venous connection
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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