Continuous milrinone infusion during preoperative anti-inflammatory therapy in inflammatory aortic aneurysm complicating severe congestive heart failure.
We report a 48-year-old man with inflammatory aortic aneurysm in the ascending aorta complicating severe heart failure due to massive aortic regurgitation. Continuous intravenous milrinone infusion was highly effective in reducing pulmonary arterial pressure and improving subjective symptoms during preoperative anti-inflammatory corticosteroid therapy over 7 weeks without any adverse effects or tolerance. Bentall's operation with a valved conduit was successfully performed after complete stabilization of inflammatory markers, and then milrinone was tapered off uneventfully. We consider that continuous milrinone infusion may be suitable for patients with surgically correctable inflammatory cardiovascular diseases complicating severe heart failure in whom maintenance of optimal hemodynamics is necessary for several weeks during preoperative anti-inflammatory corticosteroid therapy.
Takeno
Masayoshi
M
Division of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita 565-8565, Japan.
Takagi
Shuichi
S
Sakuragi
Satoru
S
Suzuki
Shoji
S
Tsutsumi
Yoshiaki
Y
Nonogi
Hiroshi
H
Goto
Yoichi
Y
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D017545:Aortic Aneurysm, Thoracic / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000627:therapeutic use*; D011300:Preoperative Care; D012720:Severity of Illness Index; D013256:Steroids
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D002316:Cardiotonic Agents; D013256:Steroids; D020105:Milrinone