Thorac cardiovasc Surg 2006; 54 DOI: 10.1055/s-2006-925740
Oral administration of tadalafil decreases mean pulmonary pressure after cardiac surgery
G Marggraf 1, D Wendt 1, U Hamsen 1, K Tsagakis 1, M Thielmann 1, H Jakob 1
1 Westdeutsches Herzzentrum Essen, Thorax- und kardiovaskuläre Chirurgie, Essen, Germany

Aims: Pulmonary hypertension, an independent risk factor for death is associated with various complications after cardiac surgery. Several drugs are in use to detach this problem. We report our initial experience with postoperative tadalafil in patients undergoing open heart surgery.

Methods: Between 06/2004 and 09/2005 we reviewed the files of 14 patients who received oral tadalafil (through stomach tube, 10-20mg per day) after cardiac surgery. Mean age was 73 years, 4 patients received coronary bypass grafting, 2 patients underwent valve replacements while 8 patients underwent combinated surgery. Hemodynamic data were recorded before, and at 2h, 4h, 8h, 12h and 24h after medication. Central venous pressure, mean arterial blood pressure and mean pulmonary artery pressure were evaluated.

Results: The Mean pulmonary artery pressure decreased by 21% (33±6 vs. 42±6mmHg p<0.0005) after therapy while mean arterial blood pressure stayed nearly identical before and after treatment and showed no significant differences (73±13 vs. 72±11mmHg, p=0.86). Central venous pressure showed no significant difference after medication (18±4 vs. 16±5mmHg, p=0.25).

Conclusion: Enteral application of tadalafil can be useful to decrease pulmonary hypertension in cardiac surgery patients. No unwanted side effects were seen when using this new drug.