Utility of inhaled nitric oxide for pulmonary hypertension in cyanotic congenital heart disease: a cohort study with propensity score matching

JOURNAL/mgres/04.03/01612956-202606000-00001/figure1/v/2025-08-19T111705Z/r/image-tiff Pulmonary hypertension can lead to hemodynamic instability and worsen the outcome after the repair of cyanotic congenital heart disease with decreased pulmonary blood flow. However, the safety and effectiveness of targeted therapy, such as inhaled nitric oxide, remain controversial. This retrospective cohort study included patients who underwent corrective repair for tetralogy of Fallot, double outlet right ventricle, or pulmonary atresia with ventricular septal defect with hypoplastic pulmonary vasculature at Fuwai Hospital between 2014 and 2021. Patients were divided into a regular treatment group and a combined treatment group depending on whether inhaled nitric oxide was prescribed. The improvement in low cardiac output syndrome within 24 hours after surgery and the main clinical outcomes during hospitalization were compared between the two groups after 1:1 propensity score matching. Compared with those in the regular treatment group, both the incidence of low cardiac output syndrome and the rate of renal replacement therapy were lower in the combined treatment group. Inhaled nitric oxide therapy is effective in the treatment of patients with pulmonary hypertension after corrective repair of cyanotic congenital heart disease.