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Sildenafil in Left Ventricular Assist Device Is Safe and Well-Tolerated

Ravichandran, Ashwin K.*; LaRue, Shane J.; Novak, Eric; Joseph, Susan A.; Schilling, Joel D.

doi: 10.1097/MAT.0000000000000626
Brief Communication: PDF Only

Right heart failure is a potentially devastating complication of mechanical circulatory support, occurring at a rate of 0.49 events per 100 patient-months. Pulmonary vasodilators such as phosphodiesterase-5 inhibitors (PDE5i) have been frequently used to unload the right ventricle in left ventricular assist device (LVAD) patients, but there is scant evidence to support this practice. The purpose of this analysis is to provide additional data regarding the safety and efficacy of the PDE5i sildenafil in a real world population of patients supported with LVADs at Washington University in St. Louis. Sildenafil use was not associated with differences in GI bleeding, stroke, mortality, HF admission, or transplantation.

From the *St. Vincent Heart Center of Indiana, Indianapolis, Indiana; Washington University in St. Louis, St. Louis, Missouri; and Baylor Heart and Vascular Hospital, Dallas, Texas.

Submitted for consideration January 2017; accepted for publication in revised form June 2017.

Disclosure: Dr. Ashwin K. Ravichandran receives speaker honoraria from Actelion Pharmaceuticals. Dr. Susan A. Joseph receives speaker honoraria from Abbott Laboratories. The other authors have no conflicts of interest to report.

Correspondence: Ashwin Ravichandran, St. Vincent Heart Center of Indiana, Indianapolis, IN 46260. Email:

Copyright © 2018 by the American Society for Artificial Internal Organs