[Effectiveness of adenosine as a pulmonary vasodilator during weaning from extracorporeal circulation after mitral valve replacement in a patient with severe pulmonary hypertension].
A 75-year-old woman with mitral stenosis and tricuspid insufficiency underwent mitral valve replacement surgery. After insertion of a catheter into the pulmonary artery, upper respiratory system pressure was seen to rise above systemic arterial pressure. To relax the pulmonary vessel, we administered adenosine, a drug that is metabolized rapidly during its first pass through the lungs before hypotension or other adverse side effects occur systemically. Adenosine decreased pulmonary artery pressure and vascular resistance, optimizing right cardiac function with successful output to extracorporeal circulation.
Charco Mora
P
P
Servicio de Anestesiología y Reanimación, Hospital Universitario de Elche.
Cantó Pastor
M
M
García Escobar
M
M
D000241:Adenosine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D005112:Extracorporeal Circulation; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D008658:Inactivation, Metabolic; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000209:etiology; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery; D014665:Vasodilator Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000601:surgery
D014665:Vasodilator Agents; D000241:Adenosine
Efectividad de la adenosina como vasodilatador pulmonar a la salida de la circulación extracorpórea tras recambio mitral en una paciente con hipertensión pulmonar grave.