Background We conducted a retrospective study to
determine the effect of oral sildenafil administrated as
monotherapy after Fontan operation in single ventricle
physiology.
Methods From January 2008 to March 2012, during two
different periods, a total of 30 pediatric patients undergoing
Fontan operation by extracardiac conduit were included in
this study. Thirteen patients were in the sildenafil group and
exclusively treated with sildenafil given at the dose of
0.35 mg/kg through a nasogastric tube and then orally every
4 h, at the start of cardiopulmonary bypass and for the first
postoperative week; then we reduced and discontinued the
therapy. The other 17 patients were in the control group. No
other vasodilator was administered in both groups. We
analyzed intraoperative and postoperative outcomes of
sildenafil administration.
Results There were no differences in mortality or operative
time. The total and relative drainage loss was lower in the
sildenafil group (PU0.0003 and 0.0045). The hemodynamic
parameters showed a better condition in the sildenafil
group, with a lower mean pulmonary artery pressure
(mPAP) (PU0.0001) and better mPAP to mean systemic
blood pressure (mSBP) ratio (PU0.0043), whereas
there was no difference in peripheral oxygen
saturation (PU0.31). The sidenafil group patients
showed other additional positive differences as well
as lower inotropic score (PU0.0005) and intubation
time (PU0.0004). No complications related to the
use of sildenafil were noted in any of the children
studied.
Conclusion This initial experience provides evidence that
sildenafil may be used in postoperative Fontan operation
with positive effectiveness
