Inhaled iloprost in eight heart transplant recipients presenting with post‐bypass acute right ventricular dysfunction

Abstract

During heart transplantation procedures, episodes of pulmonary hypertension can be successfully treated with inhaled iloprost administration, without untoward side-effects or significant systemic impact.

ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension

“…230 Inhaled iloprost has been used successfully in patients with PH and acute RV failure during and following cardiac transplantation. 231 Sildenafil has been reported to have beneficial hemodynamic effects when administered by nasogastric tube in patients undergoing cardiac surgery who develop intraoperative PH. 232 For more persistent PH following cardiac surgery, oral PAH therapy may be considered.…”

Acute and Long-Term Efficacy and Safety of Sildenafil for the Treatment of Chronic Thromboembolic Pulmonary Hypertension in a Heart Transplant Recipient

“…Sildenafil is increasingly being reported as a therapeutic option in various clinical scenarios of HTX including acute RV dysfunction and persistent PH with no occurrence of significant side effects or interactions with immunosuppressive medications [13,14] . Inhaled iloprost, devoid of interactions with immunosuppressive agents, for the use of which positive results have been reported in post-HTX acute RV dysfunction and PH [14,17] , could have been an alternative option to sildenafil for our patient; however, the latter was preferred due to the ease of administration of the oral formulation and because it is considered a more appropriate initial therapy trial. Association therapy or a switch to iloprost would have been considered in the case of an unsatisfactory response, or no response at all, to sildenafil.…”

Canadian Cardiovascular Society Consensus Conference update on cardiac transplantation 2008: Executive Summary

“…Compared with IV prostaglandin E1, inhaled nitric oxide was shown to be more effective in reducing PVR with minimal effect on systemic vascular resistance (39). Alternatively, an inhaled prostaglandin preparation (iloprost) has been used successfully in reducing PVR with minimal systemic vasodilation (40). In patients with severe RV dysfunction unresponsive to medical management, mechanical circulatory support should be considered early before irreversible end-organ dysfunction occurs.…”