Severe pulmonary arterial hypertension in a very premature baby with bronchopulmonary dysplasia: normalization with long-term sildenafil.

Bronchopulmonary dysplasia is a common adverse outcome of very premature babies treated with long-lasting ventilation and oxygen therapy. Infants with bronchopulmonary dysplasia may develop pulmonary arterial hypertension. We report on severe bronchopulmonary dysplasia in a preterm infant who developed secondary, symptomatic and progressively severe pulmonary arterial hypertension. He was treated with sildenafil for 12 months, with complete resolution of pulmonary arterial hypertension. Eighteen months after therapy discontinuation, the patient was asymptomatic, and his systolic pulmonary artery pressure was normal. Routine use of sildenafil in preterm infants with bronchopulmonary dysplasia and secondary pulmonary arterial hypertension could be the future; large studies should confirm this report.