A 69 year old woman was admitted to our hospital with mitral stenosis and tricuspid regurgitation with severe pulmonary hypertension. Mitral valve replacement (SJM 27) and tricuspid annuloplasty (Kay's method) were performed, but her postoperative course was complicated with severe right- sided heart failure manifesting oliguria, hepatomegaly and pleural effusion. Such condition were refractory to usual treatment with catecholamines and diuretics, and continous administration of amrinone (10 μg/kg/min) was started. Gradual increase of cardiac index (from 2.5 l/min/m2 to 4.1 l/min/m2), and drastic reduction of pulmonary vascular resistance (from 430 dynes · sec · cm-5 to 130 dynes · sec · cm-5) were obtained by this treatment, and the patient showed clinical improvement of heart failure. Amrinone is a drug of choice against right-sided heart failure caused by pulmonary hypertension after cardiac surgery because of its unique characteristics, pulmonary vasodilating effect as well as positive inotropic action.
|出版ステータス||出版済み - 1998|
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