Sildenafil as Adjunct Therapy to High-Dose Epoprostenol in a Patient with Pulmonary Veno-Occlusive Disease

Kuroda, Tadashi; Hirota, Hisao; Masaki, Mitsuru; Sugiyama, Shoko; Oshima, Yuichi; Terai, Kazuo; Ito, Akihiko; Yamauchi-Takihara, Keiko

doi:10.1016/j.hlc.2005.07.002

« Previous Next »Heart, Lung and Circulation
Volume 15, Issue 2 , Pages 139-142, April 2006

Sildenafil as Adjunct Therapy to High-Dose Epoprostenol in a Patient with Pulmonary Veno-Occlusive Disease

Tadashi Kuroda, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Hisao Hirota, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Mitsuru Masaki, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Shoko Sugiyama, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Yuichi Oshima, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Kazuo Terai, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Akihiko Ito, MD
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Keiko Yamauchi-Takihara, MD
- Department of Molecular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
- Corresponding author. Tel.: +81 6 6879 3835; fax: +81 6 6879 3839.

Pulmonary veno-occlusive disease is refractory to medical treatment and is generally associated with a poor prognosis. Treatment with vasodilators, such as prostacyclin, of patients with PVOD is controversial because of concerns regarding hemodynamic deterioration. Although a preferential pulmonary vasodilatory effect of a specific phosphodiesterase-5 inhibitor, sildenafil, has recently been reported in patients with primary pulmonary hypertension, little information is available regarding the effect of sildenafil on patients with pulmonary veno-occlusive disease. In the present case, remarkable improvement of hemodynamics and of clinical course was produced by adjunctive use of oral sildenafil in association with intravenous high-dose epoprostenol. These findings suggest that sildenafil may be a therapeutic option in the medical treatment of pulmonary veno-occlusive disease.

Keywords: Pulmonary veno-occlusive disease, Pulmonary hypertension, Sildenafil, Prostacyclin