First experience with sildenafil after Fontan operation: short-term outcomes
| Autor: | S. Palumbo, V. Russolillo, M. Mucerino, Carlo Vosa, Vito Mannacio, Gaetano Di Palma, Raffaele Giordano, Vincenzo Poli, S. Cioffi |
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| Přispěvatelé: | Giordano, R, Palma, Gaetano, Poli, V, Palumbo, S, Russolillo, V, Cioffi, S, Mucerino, M, Mannacio, VITO ANTONIO, Vosa, Carlo |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Pulmonary Circulation Sildenafil medicine.medical_treatment Vasodilator Agents Treatment outcome MEDLINE Administration Oral Fontan operation pulmonary hypertension sildenafil univentricular heart Fontan Procedure Sildenafil Citrate Fontan procedure chemistry.chemical_compound Medicine Humans cardiovascular diseases Postoperative Period Child Retrospective Studies business.industry Retrospective cohort study General Medicine Surgery Clinical trial surgical procedures operative Treatment Outcome chemistry Child Preschool cardiovascular system Female Cardiology and Cardiovascular Medicine business |
| Popis: | Background We conducted a retrospective study to determine the effect of oral sildenafil administrated as monotherapy after Fontan operation in single ventricle physiology. Methods From January 2008 to March 2012, during two different periods, a total of 30 pediatric patients undergoing Fontan operation by extracardiac conduit were included in this study. Thirteen patients were in the sildenafil group and exclusively treated with sildenafil given at the dose of 0.35 mg/kg through a nasogastric tube and then orally every 4 h, at the start of cardiopulmonary bypass and for the first postoperative week; then we reduced and discontinued the therapy. The other 17 patients were in the control group. No other vasodilator was administered in both groups. We analyzed intraoperative and postoperative outcomes of sildenafil administration. Results There were no differences in mortality or operative time. The total and relative drainage loss was lower in the sildenafil group (PU0.0003 and 0.0045). The hemodynamic parameters showed a better condition in the sildenafil group, with a lower mean pulmonary artery pressure (mPAP) (PU0.0001) and better mPAP to mean systemic blood pressure (mSBP) ratio (PU0.0043), whereas there was no difference in peripheral oxygen saturation (PU0.31). The sidenafil group patients showed other additional positive differences as well as lower inotropic score (PU0.0005) and intubation time (PU0.0004). No complications related to the use of sildenafil were noted in any of the children studied. Conclusion This initial experience provides evidence that sildenafil may be used in postoperative Fontan operation with positive effectiveness. |
| Databáze: | OpenAIRE |
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