Fig. 1 Protocol for oral sildenafil administration for persistent postoperative pulmonary hypertension in paediatric patients. Each dose was given via.

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Fig. 1 Protocol for oral sildenafil administration for persistent postoperative pulmonary hypertension in paediatric patients. Each dose was given via a nasogastric tube or orally after obtaining consent from parents or guardians. Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery

Fig. 2 Age distribution of the patients (n = 100). Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery

Table 1 Operations performed for patients treated with sildenafil. Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery

Fig. 3 Changes in systolic pulmonary arterial pressure before and after sildenafil treatment. (a) Individual data of the 34 cases in whom continuous pulmonary arterial (PA) pressure monitoring was available throughout the ICU stay. White open circle: data before sildenafil (SIL) administration; black closed circle: data at 6 h after reaching the maximum dose of sildenafil administration. (b) Overall change in systolic pulmonary arterial pressure before and after sildenafil treatment. Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery

Fig. 4 Changes in the postoperative transpulmonary pressure gradient (TPG). TPG normalized after administration of oral sildenafil in all right heart bypass surgeries. (a) Individual data of the five cases. (b) Overall change in TPG before and after sildenafil treatment TPG (mmHg) was calculated as mean PAP – mean CAP, where the mean PAP (pulmonary arterial pressure) is equivalent to the pressure of the superior vena cava and the mean CAP (common atrial pressure) is equivalent to the pressure of the inferior vena cava. BCPS; bidirectional cavopulmonary shunt. TCPC: total cavopulmonary connection. Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery

Table 2 Demographic data for patients treated with bosentan, an endothelin-1 dual receptor blocker, for sustained PH-related symptoms despite treatment with oral sildenafil. Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆ Eur J Cardiothorac Surg. 2010;38(1):71-77. doi:10.1016/j.ejcts.2010.01.045 Eur J Cardiothorac Surg | © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.European Association for Cardio-Thoracic Surgery