Białkowski Jacek, Szkutnik Małgorzata, Fiszer Roland
Congenital Heart Diseases and Pediatric Cardiology Department, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
Postepy Kardiol Interwencyjnej. 2013;9(3):262-4. doi: 10.5114/pwki.2013.37506. Epub 2013 Sep 16.
Two cases are presented. In the first patient (8-year-old boy) after Glenn operation without closure of pulmonary outflow from the common ventricle (SV-PA) despite transcatheter SV-PA closure increased mean pulmonary artery pressure (mPAP) (22 mm Hg) remained. After 6 months of sildenafil therapy he was catheterized again. His mPAP dropped to 10 mm Hg and a Fontan operation was subsequently performed. The second patient was a 25-year-old man, 20 years after a Fontan operation, presenting protein losing enteropathy and severe heart failure. All syndromes diminished significantly after medical therapy with sildenafil. Good clinical results of sildenafil therapy were maintained after 1 and 4 years of treatment. Chronic therapy with sildenafil can be beneficial in patients before and after the Fontan operation with elevated pulmonary artery pressure.
本文介绍了两个病例。第一例患者为一名8岁男孩，在实施格林手术（Glenn operation）后，共同心室至肺动脉（SV-PA）的肺流出道未闭合，尽管进行了经导管SV-PA封堵术，但平均肺动脉压（mPAP）仍为22 mmHg。在接受西地那非治疗6个月后，再次对其进行心导管检查。其mPAP降至10 mmHg，随后进行了Fontan手术。第二例患者为一名25岁男性，在Fontan手术后20年，出现蛋白丢失性肠病和严重心力衰竭。在接受西地那非药物治疗后，所有症状均显著减轻。在治疗1年和4年后，西地那非治疗的良好临床效果得以维持。对于Fontan手术前后肺动脉压升高的患者，西地那非长期治疗可能有益。
