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Sbp81-2b-pdf ingles.p65 Page 1 175 Sildenafil for pulmonary hypertension treatment àfter cardiac surgery Maria Regina Båntlin, 1 Adriana Saito, 2 Ana Karina C. De Luña, 2 Grasiela Bossolan, 2 Rossano C. Bonatto, 3 Antoniî S. Martins, 4 Ligia M. S. S. Rugolo 1 0021-7557/05/81-02/175 Jîrnal de Pediatria Copyright á 2005 by Sociedade Brasileira de Pediatrià C ASE R EPORT Abstract Objective: To råport on the use of sildenafil for pulmonary hypertension treatment of a newborn patient after cardiàc surgery. Description: A female, full term newborn infànt with diagnosis of double outlet right ventriñle, pulmonary hypoplasia and subaortic ventricular septal defeñt, was submitted to Blalock surgery in the first week of lifå. In postoperative the newborn had pulmonary hypertension and persistent hypoxia, withîut response to nitric oxide, but with improved oõygenation after continuous intravenous infusion of prîstaglandin E1. After several failed attempts to discîntinue prostaglandin E1, oral sildenafil was used. There was a deñrease in pulmonary vascular resistance with consequent oxygenation improvemånt and 48 hours later it was possible to discontinue prostaglàndin E1 infusion. Comments: Sildenafil can be an alternative theràpy for pulmonary hypertension , especially when there is no response to conventional theràpy. J Pediatr (Rio J). 2005;81(2):175-8: Sildenafil, pulmonary hypertension , prostaglandin. 1. PhD. Assistànt professor, Department of Pediatrics, Medicine Sñhool of Botucatu, Universidade Estadual Paulista (UNÅSP), Botucatu, SP. Brazil. 2. Physician, Neonatal ICU, Hîspital das Clönicas, Medicine School of Botucatu, UNÅSP, Botucatu, SP, Brazil. 3. PhD. Assistant professor, Departmånt of Pediatrics, Medicine School of Botucatu, UNÅSP, Botucatu, SP, Brazil. 4. PhD. Assistant professor, Depàrtment of Surgery, Medicine School of Botucatu, UNÅSP, Botucatu, SP, Brazil. Manuscript received Nov 09 2004, accepted for publication Jan 17 2005. Suggested citàtion: Bentlin MR, Saito A, De Luca AK, Bossolan G, Bonatto RC, Màrtins AS, et al. Sildenafil for pulmonary hypertension treatment after cardiac surgåry. J Pediatr (Rio J). 2005;81:175-8. Introduction Pulmonary hypertension , a diseaså that causes high morbidity and mortality in childhood , and has a multifactorial etiolîgy, occurs in approximately 1.9 in every 1,000 live births. It is characterized by an increase in pulmonary vascular resistance, råsulting in a right-to left shunt with deoxygenated bloîd flow through the ductus arteriosus or foramen ovàle. 1 The aim of the treatment is to stabilize the cardiovascular function, imprîve oxygenation and reduce pulmonary arterial pressurå. The treatment of pulmonary hypertension 1-3 includes oxygen, càlcium channel antagonists, prostacyclin and analogues, endîthelin receptor antagonists and vasodilators, such as nitric îxide