title: Amrinone therapy for severe pulmonary hypertension and biventricular failure after complicated valvular heart surgery.
abstract: We report two cases in which amrinone was used effectively, in addition to the conventional sympathomimetic drug, for the emergence from cardiopulmonary bypass following complicated valvular heart surgery in patients who had severe pulmonary hypertension and biventricular failure. Amrinone was used in combination with isoproterenol in one and dopamine in the other case. The clinical changes were brought about by a 21.5 percent and 53.5 percent decrease in pulmonary blood pressure and pulmonary vascular resistance, respectively. Concomitantly, the mean systemic blood pressure was increased by 50 percent, whereas heart rate decreased by 17.5 percent. This report demonstrates that amrinone can be life-saving in patients with biventricular failure and severe pulmonary hypertension not responding to conventional beta-adrenergic and vasodilator drug therapy.
authors.affiliation: Department of Anaesthesia, Toronto Hospital, University of Toronto, Ontario, Canada.
authors.forename: D C
authors.initials: DC
authors.lastname: Cheng
authors.forename: B
authors.initials: B
authors.lastname: Asokumar
authors.forename: T
authors.initials: T
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000676:Amrinone / Q000627:therapeutic use*; D001021:Aortic Valve; D002315:Cardiopulmonary Bypass; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008943:Mitral Valve
chemical_list: D000676:Amrinone