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Pulmonary vasodilator therapy and early postoperative outcome after modified Fontan operation

Published online by Cambridge University Press:  16 September 2014

Alberto Mendoza*
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Leticia Albert
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Sylvia Belda
Affiliation:
Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
Lidia Casanueva
Affiliation:
Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
Dolores Herrera
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Miguel A. Granados
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
José M. Velasco
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Enrique García
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Juan M. Aguilar
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
Juan V. Comas
Affiliation:
Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
*
Correspondence to: A. Mendoza, Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/nº, 28041, Madrid, Spain. Tel: +34913908508/+34913908347; Fax: +3491 390 87 72; E-mail: alberto.mendoza@salud.madrid.org

Abstract

Although mortality is low after the modified Fontan procedure, there is a significant percentage of patients with prolonged postoperative recovery. The objective of this study is to evaluate the usefulness of postoperative administration of oral sildenafil and inhaled nitric oxide on early postoperative outcome.

A prospective interventional and comparison study with a historical cohort was conducted. Between January, 2010 and March, 2013, 16 patients received oral sildenafil during immediate modified Fontan postoperative period. Inhaled nitric oxide was also administered if the patient was kept intubated 12 hours after surgery. Early postoperative outcome was compared with a historical cohort of 32 patients on whom the modified Fontan procedure was performed between March, 2000 and December, 2009.

Postoperative administration of sildenafil and nitric oxide had no influence on early postoperative outcome after the modified Fontan procedure in terms of duration of pleural effusions, mechanical ventilation time, length of stay in the ICU, and length of hospital stay.

Type
Original Articles
Copyright
© Cambridge University Press 2014 

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