Effects of oral sildenafil after palliative procedures to increase pulmonary blood flow in cyanotic heart diseases

Abstract

BackgroundContinuing efforts have been exerted to improve the outcome of palliative procedures for cyanotic congenital heart diseases. Sildenafil is known for the management of erectile dysfunction and pulmonary hypertension, but the cardiac benefits of this drug showed its impacts in the hemodynamic profile of cardiac patients.AimTo evaluate the effect of oral sildenafil on man-made shunts and vascular connection of cyanotic heart diseases.Patients and methodsThis comparative study was conducted from 2013 to 2017 on patients who had congenital cyanotic heart disease and who underwent acquired palliative procedure to increase the pulmonary blood flow. Procedures included: modified Blalock and Taussig shunts (MBTS), bidirectional cavopulmonary connections (BDCPC) or Glenn, and Fontan procedures. The pulse oximetry readings were obtained at three different stages and the results were compared with data obtained from similar procedures under the standard management regimen.ResultsTwenty-seven patients were enrolled in the case group (group 1) who received oral sildenafil compared with the control group (group 2) of patients who received the standard management which included 31 patients. The oxygen saturations showed significant difference between group 1 and group 2 in patients who had MBTS and BDCPC, while the difference was not significant in the group of patients who had Fontan procedure.ConclusionSildenafil showed significant improvement in oxygen saturation in patients with complex cyanotic heart disease who have undergone palliative surgery to increase pulmonary blood flow as MBTS and BDCPC in contrast to the patients who get Fontan procedure.