The low cost, the oral availability and the good tolerability of sildenafil make it a suitable and simple alternative therapy for secondary pulmonary hypertension including persistent postoperative pulmonary hypertension associated with ventricular septal defect in resource limited places. However, starting sildenafil early before surgery does not add a great benefit in terms of improving postoperative pulmonary hypertension or patients' outcome.

No abstract

Off-pump b-BDG can be conducted safely, with a uniform anastomosis that allows a good central pulmonary artery growth for subsequent Fontan completion. Moreover, avoiding the use of cardiopulmonary bypass is more economic and less hazardous.

Off-pump bidirectional Glenn operation without caval decompression is a safe, simple and more economic procedure.

No abstract