Vasopressin to attenuate pulmonary hypertension and improve systemic blood pressure after correction of obstructed total anomalous pulmonary venous return

Abstract

Pulmonary hypertension remains a major contributor to morbidity in the postoperative course of patients after successful surgical correction of obstructed total anomalous pulmonary venous return (TAPVR). Additionally, the postcardiotomy syndrome of low systemic vascular resistance and low cardiac output often necessitates aggressive vasopressor and inotropic support. Vasopressin has been prospectively shown in both adults and children to decrease the need for vasoactive medications in the postcardiotomy syndrome. In animal models of hypoxic pulmonary constriction, vasopressin has been shown to have properties of pulmonary vasodilation as well as systemic vasoconstriction. We hypothesized that vasopressin might decrease pulmonary vascular resistance (PVR) and thus decrease the need for vasoactive medications after surgical correction of TAPVR.