Considering heart failure secondary CHD in children a nowadays problem, of major health in the meaning of diagnosis and treatment, in this study it has been evaluated the efficacy and the tolerability of highly specific phosphodiesterase 5 inhibitor in the children’s long treatment with HF associated with PH caused by congenital systemic-to-pulmonary shunts. The study results have been proved that Sildenafil – a pulmonary vasodilator is an efficient preparation in HF associated with PH secondary CHD, improving FC (P<0,01), tolerability at effort (P<0,001), systemic O2 saturation (P<0,05), diminishing PAPm (P<0,001) and PVRI in comparison with placebo. In baby till 1 year, Sildenafil is tipically initiated at a dose of 0,5mg/kg, but in big child – the recommendated dose is 1 mg/kg, then 1 and 2 mg/kg every day, every 6 hours shows a good tolerability at this preparation, with small and unimportant reactions, forestalling the severe complications and having a benefit impact on the quality life of this children.

Considerând insuficient a cardiaca (IC) secundara malformat iilor cardiace congenitale (MCC) la copii o problema majora de sa na tate, în acest studiu a fost evaluata eficacitatea si tolerabilitatea pe termen lung a inhibitorului selectiv al fosfodiesterazei 5 la copiii cu IC si hipertensiune pulmonara (HTP) cauzata de sunturi sistemico-pulmonare. Rezultatele studiului au demonstrat ca Sildenafilul - vasodilatator pulmonar este un preparat efectiv în IC asociata cu HTP secundara MCC, îmbunatatind CF (P<0,01), tolerabilitatea la efort (P<0,001), saturatia O2 sistemica (P<0,05), functia sistolica a VD (P<0,05), diminueaza PAPm (P<0,001) si IRVP în comparatie cu placebo. La copiii sugari doza initiala este de 0,5mg/kg, urmata de 1 mg/kg la o tolerabilitate buna , iar la copiii mai mari, respectiv 1 s i 2 mg/kg zilnic fiecare 6 ore. Preparatul a demonstrat o tolerabilitate buna cu reactii adverse minore si neînsemnate, previne complicatiile severe si are un impact benefic asupra calitatii vietii acestor copii.