Key result
Preoperative sildenafil reduces PASP by ~15 mmHg one month after mitral valve replacement.
Why the study?
Mitral valve diseases are commonly associated with pulmonary hypertension, prompting evaluation of the effect of preoperative sildenafil on outcomes following mitral valve replacement.
Does preoperative sildenafil improve postoperative outcomes and reduce pulmonary hypertension in patients undergoing mitral valve replacement with pulmonary hypertension?
Population
67 patients undergoing mitral valve replacement with systolic pulmonary artery pressure >50 mmHg
Comparison
Preoperative sildenafil for 1 week vs 1 month vs no sildenafil
Design
Prospective randomized study
Follow-up
One month postoperatively
Authors
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Supports preoperative sildenafil to lower post-MVR pulmonary pressures; extends RCT evidence for PDE5 inhibition in valvular PH.
RCT (n=67)
Randomized into three groups
Does preoperative sildenafil improve postoperative outcomes and reduce pulmonary hypertension in patients undergoing mitral valve replacement with pulmonary hypertension?
Absolute Event Rate: 28.3% vs 43.12%
p-value: p=<0.001
Preoperative administration of sildenafil for one week or one month significantly reduces postoperative pulmonary hypertension and improves early postoperative outcomes in patients undergoing mitral valve replacement.
Ibrahim et al. (2020) conducted an RCT in Mitral valve diseases with pulmonary hypertension (n=67). Preoperative oral sildenafil vs. No sildenafil was evaluated on Pulmonary artery systolic pressure one month postoperatively (mmHg) (p=<0.001). Preoperative oral sildenafil significantly reduced pulmonary artery systolic pressure 1 month after mitral valve replacement compared to no sildenafil (28.3 vs 43.12 mmHg; P<0.001).
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