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Is sildenafil effective for treating pulmonary hypertension after pediatric heart surgery?

Department of Paediatric Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill NHS Trust, Dalnair Street, Glasgow G3 8SJ, UK

*Corresponding author. Tel.: +44 141 201 0269; fax: +44 141 201 9204.

E-mail address: drrajashahzad{at}hotmail.com (S.G. Raja).

A best evidence topic in pediatric cardiac surgery was written according to a structured protocol. The question addressed was whether sildenafil was effective in treating postoperative pulmonary hypertension after pediatric heart surgery. Altogether 28 papers were found using the reported search, of which three represented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses were tabulated. We conclude that oral sildenafil may be useful in reducing pulmonary vascular resistance and can be considered for treatment of postoperative pulmonary hypertension after pediatric heart surgery. However, evidence from a large, multicenter, randomized controlled trial is needed to validate the safety and efficacy of sildenafil for use in postoperative pediatric cardiac surgical patients.

Key Words: Evidence-based medicine; Sildenafil; Pulmonary hypertension; Pediatric heart surgery