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Giardini et al. 1 reported on the increase of peak oxygen uptake at a cardiopulmonary exercise test in Fontan patients after a single dose of sildenafil. This is an excellent study to outline that there are pulmonary vascular changes in these patients. These small but important changes cause an impaired inflow pattern of the single ventricle and curtail the whole cardiovascular performance.However, …

Effect of sildenafil on haemodynamic response to exercise and exercise capacity in Fontan patients