title: [Oral sildenafil citrate as an effective alternate in the treatment of postoperative pulmonary hypertensive crisis after congenital heart surgery].
abstract: A five-month-old girl of Down syndrome underwent a corrective surgery for complete atrioventricular septal defect. Her postoperative course was complicated with pulmonary hypertensive (PH) crises despite nitroglycerin (NTG) infusion and inhaled nitric oxide (NO). Sildenafil citrate, a phosphodiesterase 5 inhibitor, was administered through a nasogastric tube at a starting dose of 0.3 mg/kg by stepwise increment to the maximum dose of 2 mg/kg 4 hourly. Sildenafil citrate dramatically lowered pulmonary arterial pressure and the patient was weaned from NTG and NO without PH crisis. There was no side effect after sildenafil citrate administration. Oral sildenafil citrate is a safe and potent adjunct to the existing therapies for postoperative PH in infants after open heart surgery.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Nemoto
authors.forename: E
authors.initials: E
authors.lastname: Umehara
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Doi
authors.forename: Y
authors.initials: Y
authors.lastname: Hiraumi
authors.forename: S
authors.initials: S
authors.lastname: Yokoyama
authors.forename: K
authors.initials: K
authors.lastname: Inui
authors.forename: Y
authors.initials: Y
authors.lastname: Sakakibara
authors.forename: T
authors.initials: T
authors.lastname: Koyama
authors.forename: N
authors.initials: N
authors.lastname: Ohno
authors.forename: T
authors.initials: T
authors.lastname: Nishina
authors.forename: M
authors.initials: M
authors.lastname: Komeda
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D006348:Cardiac Surgical Procedures / Q000379:methods; D004314:Down Syndrome / Q000150:complications; D005260:Female; D006343:Heart Septal Defects / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D007223:Infant; D009569:Nitric Oxide / Q000008:administration & dosage; D010879:Piperazines / Q000627:therapeutic use*; D011183:Postoperative Complications; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D009569:Nitric Oxide; D000068677:Sildenafil Citrate