[Successful anesthetic management of patients with poor ventricular function using the phosphodiesterase III inhibitor, olprinone, during major cardiovascular procedures].
We administered olprinone, a newly developed phosphodiesterase III inhibitor, commencing before induction of general anesthesia to patients with poor ventricular function during major cardiovascular procedures. Case 1 patient underwent off-pump CABG for acute myocardial infarction. Although he was in a shock state, olprinone improved the contractility of viable myocardium, increased the cardiac index, and decreased the pulmonary artery pressure. Case 2 patient underwent off-pump CABG for unstable angina. Olprinone significantly increased the cardiac index and the mixed venous oxygen saturation. Case 3 patient underwent graft replacement for rupture of a dissected descending aorta. Although he showed ischemic cardiomyopathy with diffuse hypokinetic left ventricle, olprinone drastically improved the contractility of the heart. Olprinone was very effective for improving ventricular dysfunction; its institution prior to induction of anesthesia made successful anesthetic management possible without resorting to a mechanical assist device like the intra-aortic balloon pump.
Chang
Kyung-ho
KH
Department of Anesthesiology, Faculty of Medicine, University of Tokyo, Tokyo 113-8655.
Ogawa
Makoto
M
Bougaki
Masahiko
M
Sugano
Takayuki
T
Hanaoka
Kazuo
K
D000368:Aged; D000768:Anesthesia, General; D000789:Angina, Unstable / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011728:Pyridones / Q000627:therapeutic use*; D016276:Ventricular Function / Q000187:drug effects
D002316:Cardiotonic Agents; D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D011728:Pyridones; C059498:olprinone