RT Journal Article SR Electronic T1 The use of perioperative intravenous sildenafil in patients with mitral valve disease and co-existent pulmonary hypertension during cardiac surgery JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP p2381 VO 38 IS Suppl 55 A1 B.P. Madden A1 S. Sharma A1 E. Holden A1 Y. Looney A1 S.N. Fletcher A1 A. Sheth YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/p2381.abstract AB Introduction: Patients who have mitral valve (MV) disease with associated pulmonary hypertension (PH) may develop acute rises in pulmonary vascular resistance (PVR) perioperatively.Such pulmonary hypertensive crises may significantly increase perioperative morbidity and mortality. Although there is limited experience with agents to reduce the PVR, their use may be associated with systemic hypotension.Aim: To evaluate the safety and haemodynamic effects of intravenous (IV) sildenafil perioperatively, in patients with PH and MV disease undergoing cardiac surgery.Method: Nine patients, two males and seven females, age range 64 to 81 (median 76) years, with PH, mean pulmonary artery pressure range 30 to 56 (median 43) mmHg, associated with MV disease, who had MV surgery, received IV sildenafil (1mg/ml) at a rate of 1mg/kg for one hour in the immediate post operative period.Pulmonary and systemic haemodynamic measurements were recorded at ten-minute intervals.Results: A statistically significant reduction (p=0.006) in PVR was observed.There was a trend towards improvement in the cardiac index (CI), although it did not reach statistical significance (p=0.059).Mean systemic arterial pressure remained stable and no detrimental effect on other haemodynamic parameters was noted.Discussion: Our study suggests that perioperative use of IV sildenafil is safe and not associated with systemic hypotension.We observed a favourable response in PVR and a trend towards improvement in CI.We suggest that IV sildenafil should be considered for selected patients with MV disease and PH who require MV surgery.