Amrinone therapy for severe pulmonary hypertension and biventricular failure after complicated valvular heart surgery.

Abstract

We report two cases in which amrinone was used effectively, in addition to the conventional sympathomimetic drug, for the emergence from cardiopulmonary bypass following complicated valvular heart surgery in patients who had severe pulmonary hypertension and biventricular failure. Amrinone was used in combination with isoproterenol in one and dopamine in the other case. The clinical changes were brought about by a 21.5 percent and 53.5 percent decrease in pulmonary blood pressure and pulmonary vascular resistance, respectively. Concomitantly, the mean systemic blood pressure was increased by 50 percent, whereas heart rate decreased by 17.5 percent. This report demonstrates that amrinone can be life-saving in patients with biventricular failure and severe pulmonary hypertension not responding to conventional beta-adrenergic and vasodilator drug therapy.