Milrinone for long-term pharmacologic support of the status 1 heart transplant candidates.
BACKGROUND
We determined the efficacy of long-term therapy with milrinone alone or in combination with inotropic agents in status 1 heart transplant candidates as a pharmacological support until heart transplantation.


METHODS
Hemodynamic and biochemical variables were recorded in 29 status 1 men with symptoms of severe congestive heart failure, who received continuous intravenous milrinone alone (group 1, n = 21) or in combination with inotropic agents (group 2, n = 8) while awaiting heart transplantation.


RESULTS
Symptomatic relief was noted in all patients of both groups without any preoperative deaths. One patient (4.8%) of group 1 died on the second day and 1 patient of group 2 died 16.4 months after transplantation. Although pulmonary capillary wedge pressure (group 1, p = 0.021; group 2, p = 0.0002), mean pulmonary artery pressure (group 1, p = 0.051; group 2, p = 0.004), and pulmonary vascular resistance (group 1, p = 0.0026; group 2, p = 0.056) were reduced by 1 hour after the onset of treatment and maintained unchanged until transplantation, the changes in mean pulmonary artery pressure in group 1 and pulmonary vascular resistance in group 2 were statistically insignificant except in the posttransplantation period.


CONCLUSIONS
Long-term therapy with milrinone in combination with inotropic agents is safe and effective when only milrinone infusion is inadequate for pharmacologic support in status 1 candidates.
Canver
C C
CC
Division of Cardiothoracic Surgery, Albany Medical College, New York 12208-3479, USA. canverc@mail.amc.edu
Chanda
J
J
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D016027:Heart Transplantation; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000188:drug therapy* / Q000401:mortality; D011300:Preoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D014850:Waiting Lists
D002316:Cardiotonic Agents; D020105:Milrinone