Pre-op oral sildenafil for children with CHD prior to cardiopulmonary bypass

Vassalos et al,¹² in a randomised trial, compared the effects of oral sildenafil (0.5 mg/kg) and placebo, administered the day before cardiac surgery, in 24 children. Postoperatively, mean pulmonary vascular resistance and oxygenation index remained unchanged, whilst oxygen delivery and bi-ventricular systolic function were significantly reduced in the sildenafil group. In this trial, pre-operative sildenafil did not affect postoperative pulmonary vascular resistance. There was, however, a negative impact on ventricular function and oxygenation. Therefore, sildenafil is not recommended for this particular indication.