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Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
(Email: snemoto@poh.osaka-med.ac.jp).
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To the Editor:
We appreciate the thoughtful comments of Drs Soueide and Rassi [1] regarding our article [2]. As pointed out [1], it is well recognized that cyclic guanosine monophosphate (cGMP) plays a clinically important role in maintaining pulmonary vascular tone (ie, pulmonary vasodilation, even immediately after cardiac surgery). Along with cGMP production therapy with inhaled nitric oxide for pulmonary hypertension [3], sildenafil has recently been recognized as an effective treatment option for various types of pulmonary hypertension and impaired pulmonary circulation [4, 5] by inhibiting degradation of cGMP. In fact, both inhaled nitrous oxide
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