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Lost Unilateral Capillary Perfusion During Nonpulsatile Pulmonary Circulation: Successful Recovery by Oral Sildenafil

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Abstract

Good status of pulmonary perfusion is essential for a successful outcome after the Fontan procedure. Increased pulmonary pressure and vascular resistance, small size of the pulmonary arteries, and significant branch stenoses reflect some of the main problems causing failing Fontan circulation. Here we report a child who underwent a staged Fontan procedure with subsequent subtotal loss of the left-sided pulmonary perfusion, although branch stenosis was successfully treated by stent implantation. Oral sildenafil caused restoration of the capillary vascular bed, improved left-sided lung perfusion, and resulted in significant clinical benefit.

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Acknowledgments

The surgical procedures were performed by V. H. at the Universitäres Herzzentrum Hamburg, Hamburg, Germany (stages I and II) and at the Deutsches Kinderherzzentrum, Asclepios Klinik Sankt Augustin GmbH, Sankt Augustin, Germany (stage III).

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Authors and Affiliations

  1. Department for Congenital Heart Disease/Pediatric Cardiology, Klinikum Links der Weser, 28277, Bremen, Germany

    Levent Celik, Konstantin Papakostas & Jan-Hendrik Nürnberg

  2. MR and PET/CT Center, Klinikum Bremen Mitte, 28177, Bremen, Germany

    Markus Lentschig

  3. Department for Pediatric Cardiothoracic Surgery, Deutsches Kinderherzzentrum Sankt Augustin, 53757, Sankt Augustin, Germany

    Victor Hraska

Authors
  1. Levent Celik
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  2. Konstantin Papakostas
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  3. Markus Lentschig
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  4. Victor Hraska
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  5. Jan-Hendrik Nürnberg
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Correspondence to Levent Celik.

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Celik, L., Papakostas, K., Lentschig, M. et al. Lost Unilateral Capillary Perfusion During Nonpulsatile Pulmonary Circulation: Successful Recovery by Oral Sildenafil. Pediatr Cardiol 33, 370–374 (2012). https://doi.org/10.1007/s00246-011-0136-0

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  • DOI: https://doi.org/10.1007/s00246-011-0136-0

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