Effect Of Oral Sildenafil Citrate On Pulmonary Vasodilatory And Myocardial Protection In Rheumatic Heart Disease Patients With Pulmonary Hypertension In Cardiopulmulnary Bypass

Objective:To evaluated the effects of sildenafil on hemodynamics and cardioprotection in rheumatic heart disease patients with pulmonary hypertension undergoing valvular heart surgery during cardiopulmonary bypass(CPB).Methods:After pulmonary arterial catheter insertion,patients with mean pulmonary arterial pressures(MPAP)greater than 30 mm Hg were eventually included in this study.Twenty-eight cases were randomly divided into the control group(n=14),and the experimental group(n=14).Each patient in the experimental group was given 100 mg SIL(orally by nasal gastric tube)after induction of anesthesia.In control group,patients were placebo - controlled. Hemodynamic variables were measured after induction of anesthesia,at O,20,40,and 60 minutes after medication.Blood samples were taken to determine the serum concentrations of CK-MB and cTn-T before CPB,at 2,6 and 16h after aortic open-clamp.Results:Compared with the control group,the mPAP and mPAP/PmSAP was significantly reduced(P＜0.01)in the experimental group.And the levels of CK-MB at 2h after aortic open-clamp and cTn-T at 16h after aortic open-clamp in the experimental group were significantly lower than those in control group(P＜0.05).Conclusion:Sildenafil produced significant pulmonary vasodilatory effect in cardiac surgical patients with pulmonary hypertension and beneficial effects such as myocardial protection.