title: Effects of milrinone for right ventricular failure after left ventricular assist device implantation.
abstract: Right ventricular failure after left ventricular assist device implantation sometimes requires additional mechanical right ventricular support. The effectiveness of nitrates, prostaglandin, or nitric oxide inhalation in such cases has already been reported. However, there are few reports on the administration of phosphodiesterase inhibitor for right ventricular failure after left ventricular assist device implantation. We report two patients with right ventricular failure after left ventricular assist device implantation successfully treated with milrinone. Both had residual pulmonary hypertension due to high pulmonary vascular resistance after left ventricular assist device implantation. However, intravenous milrinone caused a significant reduction in pulmonary vascular resistance and an increase in left ventricular assist device flow. Milrinone acts as both an inotropic agent and a direct vasodilator, and thus may avoid the need for mechanical support for right ventricular failure due to residual pulmonary hypertension after left ventricular assist device implantation.
authors.affiliation: Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University. kiharas@msx.upmc.edu
authors.forename: Shin'ichiro
authors.initials: S
authors.lastname: Kihara
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawai
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukuda
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Aomi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Koyanagi
mesh_terms: D000293:Adolescent; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000627:therapeutic use*; D010138:Pacemaker, Artificial; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D020105:Milrinone