Sildenafil—a possible treatment for acute pulmonary hypertension during cardiac surgery

Wendy Wheeler, MD, Shelly Hayes, MD, Ngo Nguyen, MD, Anthony M. Cilla, MD, Joseph Rybowicz, PharmD, Comeco C. Jones, RN, Michael A. E. Ramsay, MD, Shelley A. Hall, MD, Dan Meyer, MD, John Capehart, MD, Michael E. Jessen, MD, and Steves Ring, MD

From the Departments of Anesthesia and Pain Management (Wheeler, Hayes, Nguyen, Cilla, Jones, Ramsay), Pharmacy Services (Rybowicz), Cardiology (Hall), and Cardiothoracic Surgery (Meyer, Capehart, Jessen, Ring), Baylor University Medical Center, Dallas, Texas.

Corresponding author: Michael A. E. Ramsay, MD, Department of Anesthesia and Pain Management, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, Texas 75246 (e-mail: docram@baylorhealth.edu).

A new therapy being examined for the treatment of primary and secondary pulmonary hypertension is the administration of oral sildenafil. Sildenafil is a selective vasodilator that prolongs the action of cyclic guanosine monophosphate by selective inhibition of phosphodiesterase type 5, of which the lung has a rich supply. This action potentiates the effect of endogenously produced nitric oxide in the lung with resulting pulmonary vasodilatation. This report describes an early experience of administering sildenafil to a patient with pulmonary hypertension and right ventricular dysfunction who was undergoing cardiac transplantation surgery at Baylor University Medical Center. (BUMC Proceedings 2002;15:13-15)