Dr David J Goldberg attained his qualifications as a paediatric cardiologist from Yale; he is now a fellow of The Children’s Hospital of Philadelphia and leader of the research team into maintenance support for children with ventricle defects.

The juveniles taking part in the survey had previously undergone a Fontan operation. This procedure reroutes venous blood flow from the right atrium through to the pulmonary arteries, avoiding going into the right ventricle. It is used to treat complicated infantile heart defects and is the third part of the treatment for this ailment.

Youngsters with single-ventricle problems will have lasting health problems and there is also a possibility of premature death. Even though the treatment has advanced over the last few decades, it is still a difficult ailment to correct. As the medical procedure to rearrange the defect is not able to make it function in the same way as a normal circulatory system would. The blood flow is redirected via veins straight to the lungs; this makes the lungs resistant to the blood and makes energy levels less effective.

Children from a cross section were chosen for the study, 27 of them including some young adults. They were either given sildenafil or a sugar tablet for the first six weeks. After a six week rest the medication was swapped around, so all the participants over the three months received the research medication and a placebo. Echocardiograms were used to record the information to compare with the MPI (myocardial performance index), this is a chart that registers how well the heart is circulating blood.

Volunteers that took part in the analysis had the Fontan procedure as a very young child, giving an average of eleven years lapse. Also the even age range for the participants was fourteen years. The medication being used is Sildenafil (sold as Viagra) which is widely used for pulmonary hypertension and was found during its first trials in the early 90’s that it helped males with erectile dysfunction problems. (While other treatments for Ed exist, such as Tadalafil (Cialis), these drugs, as yet, dont seem to have the versatility of Viagra in being able to treat other conditions.)

It also helps with flying sickness and a lot of mountain climbers take it to counteract altitude problems. So as the treatment of adults with major hearts conditions has been very successful, Dr Goldberg is hoping to have the same outcome with children and their differing heart complaints.

Research was on its phase 2 of the trial using the Sildenafil post Fontan procedure, with the previous one recording physical activity whilst taking the medication or a placebo. Preventing high levels of enzyme phosphodiesterase E5 (PDE5) seems to be of benefit to sufferers of certain heart diseases and this improvement might be possible with single-ventricle juveniles.

In a statement Dr Goldberg said "If sildenafil is safe over the medium and long-term, and if it produces durable functional improvements, patients with single-ventricle heart disease could have their first effective long-term treatment." His research team are hoping for the go-ahead for a larger and extended investigation into the use of the medication in children.

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Written by Graham hall