Sildenafil for pulmonary hypertension due to left-toright shunt after corrective procedure

Journal Title: Paediatrica Indonesiana - Year 2015, Vol 55, Issue 5

Abstract

Background Pulmonary arterial hypertension (PAH) is a common complication seen in those with a left-to-right shunt congenital heart defect (CHD). Corrective procedures by surgery or catheterization are the therapies of choice for reversible PAH. Since morbidity and mortality due to PAH after correction is high, sildenafil has been used as a selective vasodilator of the pulmonary artery, in order to decrease pulmonary arterial pressure. Objectives To evaluate the effect of sildenafil on pulmonary arterial pressure and clinical outcomes after left-to-right shunt CHD corrective procedures. Methods Left-to-right shunt patients aged < 18 years scheduled for corrective treatment were randomized in a double-blind fashion, to receive either oral sildenafil or placebo, given on days 3 to 30 after the corrective procedure. Clinical and pulmonary arterial pressures were evaluated by echocardiography before, 3 days after, and 30 days after the corrective procedure. Results From July 2013 to June 2014, 36 patients were included in the study: 17 in the placebo and 19 in the sildenafil groups. There were no differences in pulmonary arterial pressure or in clinical outcomes after corrective procedure between the two groups. There were no adverse events during the treatment. Conclusion Sildenafil has little effect on decreasing pulmonary arterial pressure, as most of our subjects seem to have hyperkinetic PAH. As such, pulmonary arterial pressure returns to normal soon after corrective procedures.

Authors and Affiliations

Dyahris Kuntartiwi, Piprim Yanuarso, Sudigdo Sastroasmoro

Keywords

Related Articles

Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum

Congenital obstructive posterior urethral membranes (COPUM) is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This cong...

Consumption of energy-dense, nutrient-poor foods and hypertension in obese children

Background Obesity has become an increasingly important medicalproblem in children. Obesity-induced hypertension in childhoodshould be considered as a chronic medical condition that is likelyto require long-term manageme...

Exposure to cow’s milk as a prognostic factor for atopic dermatitis during the first three months of life

Background The incidence of atopic dermatitis has increased inthe early life of children. Cow's milk, the first foreign protein towhich infants are exposed, is predicted to be a prognostic factorof atopic dermatitis.Obje...

Nutritional status of soil-transmitted helminthiasis-infected and uninfected children

Background Soil-transmitted helminth (STH) infections remain a public health problem in developing countries. Their prevalence is particularly high in rural areas with people of low socioeconomic level. A single or mixed...

Serial blood lactate levels as a prognostic factor for sepsis mortality

Background Sepsis is a major health problem in children and aleading cause of death. In recent decades, lactate has been studiedas a biomarker for sepsis, and as an indicator of global tissuehypoxia, increased glycolysis...

Download PDF file
  • EP ID EP448563
  • DOI 10.14238/pi55.5.2015.257-62
  • Views 75
  • Downloads 0

How To Cite

Dyahris Kuntartiwi, Piprim Yanuarso, Sudigdo Sastroasmoro (2015). Sildenafil for pulmonary hypertension due to left-toright shunt after corrective procedure. Paediatrica Indonesiana, 55(5), 257-62. https://europub.co.uk/articles/-A-448563