Key result
Preoperative sildenafil reduces postoperative TVPG by ~11 mmHg vs control after mitral valve replacement.
Why the study?
To determine the role of preoperative administration of sildenafil on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery.
Does preoperative oral sildenafil improve postoperative TVPG, LVEF, and NYHA class in patients with mitral valve disease and pulmonary hypertension undergoing mitral valve replacement?
Population
310 patients with mitral valve disease undergoing mitral valve replacement
Comparison
Preoperative oral sildenafil vs no oral sildenafil
Design
Randomized control trial
Authors
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May support preoperative sildenafil before mitral valve replacement; hypothesis-generating and requires randomized confirmation before practice change.
RCT (n=310)
Randomized
No
Does preoperative oral sildenafil improve postoperative TVPG, LVEF, and NYHA class in patients with mitral valve disease and pulmonary hypertension undergoing mitral valve replacement?
Absolute Event Rate: 32.54% vs 43.08%
p-value: p=<0.001
Preoperative oral sildenafil effectively reduces postoperative pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement.
Khilji et al. (2021) conducted an RCT in Pulmonary hypertension with mitral valve disease (n=310). Oral sildenafil vs. No sildenafil was evaluated on Postoperative tricuspid valve pressure gradient (TVPG) (p=<0.001). Preoperative oral sildenafil significantly reduced postoperative tricuspid valve pressure gradient compared to control (32.54 vs 43.08 mmHg, p<0.001) in patients undergoing mitral valve replacement.
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