Perspective
Pulmonary vasodilators in LVAD patients
Author(s): Samuel Jhones
In individuals with end-stage left heart failure, a left ventricular assist device can save their lives. The pulmonary arterial pressure, wedge pressure, and pulmonary vascular resistances all fall as a result. Despite sufficient LV unloading, post capillary pulmonary hypertension remains in a considerable proportion of individuals. The pulmonary venous congestion and accompanying drop in nitric oxide levels could be one explanation. This finding has heightened interest in pulmonary vasodilators, particularly Phosphodiesterase 5 inhibitors (PD-5 I). They improve Nitric Oxide (NO) signaling by increasing the availability of cyclic guanosine monophosphate. Sildenafil has been shown to significantly reduce mPAP and PVR 2-4 weeks following LVAD installation and to wean from inotropic support within the first 72 hours, allowing the patient to be successfully intubated. However, while the r.. Read More»
DOI:
10.37532/puljhr.22.5(2).19-20
