title: [Nitrid oxide, levosimendan and sildenafile in a patient with right ventricle dysfunction and severe pulmonary hypertension after cardiac surgery].
abstract: Pulmonary hypertension (PHT) and the resulting right ventricle dysfunction are important risk factors in patients who undergo cardiac surgery. The treatment of PHT and right ventricle dysfunction should be focused on maintaining the correct right ventricle after load, improving right ventricle function and reducing the right ventricle pre-load and therefore reducing pulmonary vascular resistance by means of vasodilators. A combined therapy of vasodilators and medicines which have different mechanisms of action, is becoming an option for the treatment of PHT. We present a 65 year old woman that suffered from mitral regurgitation, aortic valve disease, tricuspid and ascending aortic dilation with 115mmHg of pulmonary artery pressure (by ultrasound evaluation). The patient was operated on of mitral, aortic valve and tricuspid plastia and proximal aortic artery plastia as well. Previosly to surgery the patient suffered right ventricle dysfunction and PHT and was treated with nitric oxide, intravenous sildenafil and levosimendan. Subsequent evolution was satisfactory, PHT being controlled, without arterial hypotension nor respiratory alterations.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital La Fe, Valencia, España. Electronic address: laleixandre@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Aleixandre
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital La Fe, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Cortell
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital La Fe, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Vicente
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital La Fe, Valencia, España.
authors.forename: P
authors.initials: P
authors.lastname: Herrera
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital La Fe, Valencia, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Loro
authors.affiliation: Servicio de Cirugía Cardiovascular, Hospital La Fe, Valencia, España.
authors.forename: F
authors.initials: F
authors.lastname: Valera
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery*; D004280:Dobutamine / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D009569:Nitric Oxide / Q000627:therapeutic use*; D009638:Norepinephrine / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011724:Pyridazines / Q000627:therapeutic use*; D000068677:Sildenafil Citrate / Q000627:therapeutic use*; D000077464:Simendan; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy* / Q000209:etiology
chemical_list: D006835:Hydrazones; D011724:Pyridazines; D014665:Vasodilator Agents; D009569:Nitric Oxide; D000077464:Simendan; D004280:Dobutamine; D000068677:Sildenafil Citrate; D009638:Norepinephrine
keywords: Cardiac surgery; Cirugía cardíaca; Disfunción del ventrículo derecho; Hipertensión pulmonar; Levosimendan; Levosimendán; Nitric oxide; Pulmonary hypertension; Right ventricle dysfunction; Sildenafil; Sildenafilo; Óxido nítrico