The Journal of Heart and Lung Transplantation
Abstract19: Use of Sildenafil for Prevention of Right Heart Failure in Heart Transplant Recipients with Pulmonary Hypertension
Section snippets
Purpose
The aim of our study is to demonstrate the impact of sildenafil on pulmonary circulation in HTx patients.
Methods and Materials
We present our experience in 11 patients (8 males and 3 females), early after heart transplantation, in whom sildenafil was used for treatment of right ventricular dysfunction and pulmonary hypertension confirmed by Swan-Ganz right heart cathetrization and echocardiography. In selected graft recipients with pulmonary hypertension and significant tricuspid regurgitation (TR), in addition to conventional inodilator support and alprostan, we administered 1-2mg per kilogram of sildenafil.
Results
Mean age was 53±8,6years. Preoperative hemodynamic data showed systolic pulmonary arterial pressure (SPAP) 46,6± 10,1mmHg, cardiac output (CO) 2,9±0,5l/min., transpulmonary gradient (TPG) 18,9±4,9mmHg and pulmonary vascular resistence (PVR) 6,9±1,9WU. Within 24-72 hours after the administration of sildenafil, acute right ventricular dysfunction resolved rapidly in all cases, TPG decreased significantly (18,9mmHg vs. 11mmHg) and so did PVR (6,9WU vs. 2,5 WU). Tricuspid regurgitation decreased
Conclusions
Sildenafil may be effectively used for treatment of acute right ventricular dysfunction in heart recipients with pulmonary hypertension.