Why the study?
Does the combination of sildenafil and l-arginine improve clinical outcomes in a pregnant woman with Eisenmenger syndrome?
Does the combination of sildenafil and l-arginine improve clinical outcomes in a pregnant woman with Eisenmenger syndrome?
The combination of sildenafil and l-arginine may be an effective therapy for managing severe pulmonary hypertension due to Eisenmenger syndrome during pregnancy.
May support adjunctive sildenafil plus l-arginine in pregnant Eisenmenger syndrome; hypothesis-generating and requires prospective validation.
In Brief BACKGROUND: Eisenmenger syndrome in pregnancy may be a life-threatening disease despite recent additions to the treatment options. CASE: We present a woman with severe pulmonary hypertension due to Eisenmenger syndrome treated during pregnancy and delivery and postpartum with l-arginine and sildenafil to enhance the nitric oxide pathway. This combination was associated with significant improvement in the mother's clinical and hemodynamic condition and fetal well-being. CONCLUSION: The concomitant use of sildenafil and l-arginine for the management of pulmonary hypertension in pregnancy, combined with multidisciplinary care, permitted a good outcome for the mother and her infant. Enhancement of the nitric oxide–cyclic guanine monophosphate pathway by sildenafil and l-arginine may constitute effective therapy for pulmonary hypertension in pregnancy.
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Lacassie et al. (2004) studied this question.
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