First experience with sildenafil after Fontan operation

Abstract

This initial experience provides evidence that sildenafil may be used in postoperative Fontan operation with positive effectiveness.

The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation

“…A retrospective study by Giordano et al reported that sildenafil significantly reduced ascites and pleural fluid effusion, the need for vasoactive drugs, and shortened mechanical ventilation time. 5 In contrast, a study by Mendoza et al found that sildenafil and inhaled nitric oxide did not influence the duration of pleural effusion, mechanical ventilation, or the lengths of PICU or hospital stay. 6 Sildenafil reduced the pulmonary vascular resistance, but it also increased systemic vasodilatation, which may increase the need for post-operative fluid resuscitation.…”

“…et al, the mechanical ventilation time shortened simultaneously with the introduction of the new protocol and the use of sildenafil when compared to historical controls. The mean intubation time in the sildenafil group was 15.5 ± 4 hours and 23.3 ± 6 hours in the historical control group 5. Whether earlier extubation was due to the use of sildenafil or the awareness of the benefits of early extubation remains a question.…”

“…4 Therefore, in 2006, our institution started the administration of sildenafil after the TCPC operation for occasional patients and usually later than 24 hours after the operation, and since 2009, the majority of the patients received their first dose of sildenafil pre-operatively in the morning of the operation.However, the benefits of sildenafil have been controversial in the two recent retrospective Fontan series. 5,6 Our aim in this study was to analyze the effect of prophylactic sildenafil on pleural and peritoneal effusions during the first post-operative day (POD) after the TCPC surgery. We hypothesized that the…”

“…However, the benefits of sildenafil have been controversial in the two recent retrospective Fontan series. 5,6 Our aim in this study was to analyze the effect of prophylactic sildenafil on pleural and peritoneal effusions during the first post-operative day (POD) after the TCPC surgery. We hypothesized that the…”

Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV‐INHIBITION study design

“…However, the level of clinical evidence for sildenafil in this indication remains limited, with case reports, small and uncontrolled cohorts, retrospective studies, and studies with a short exposure time to treatment (e.g. maximum of 6 weeks) . Therefore, a better selection of patients who may benefit from pulmonary vasodilator is necessary and with a sufficiently long exposure time of treatment.…”