• Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tatsuo Iwasaki, Kenji Baba, Shinichi Otsuki, Yasuhiro Kotani, Shingo Kasahara, and Hiroshi Morimatsu.
• Anesthesiology and Resuscitology, Okayama University Hospital, Kitaku, Okayama, Japan. Electronic address: tyskanazawa@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2021 Jul 1; 35 (7): 2073-2078.

ObjectivesThe aim of this study was to investigate whether milrinone infusion improved one-year survival in patients who underwent the Norwood-Sano procedure.DesignA retrospective observational study.SettingA single-institution university hospital.ParticipantsChildren who underwent the Norwood-Sano procedure from January 2008 to December 2014.InterventionsPatients were categorized into two groups: group E+D, who received routine epinephrine and dopamine infusion, and group M, who received routine milrinone infusion for intra- and postoperative inotropic support.Measurements And Main ResultsThe primary outcome of this study was one-year survival after the Norwood-Sano procedure. A total of 45 patients were included (group E+D, 22; group M, 23). One-year survival in group M was significantly higher than that in group E+D (95.7% [22/23] v 72.7% [16/22], p = 0.03). A Kaplan-Meier curve also showed that one-year survival in group M was significantly higher than that in group E+D (p = 0.04), from the result of the log-rank test. The number of patients who had any arrhythmias in the intensive care unit (ICU) was significantly lower in group M than in group E+D (21.7% [5/23] v 50% [11/22], p = 0.03). The duration of ICU stay did not have statistical difference between groups (group M 19; interquartile range [IQR], 15-28) v group E+D 19.5 (IQR, 16.3-35.5) days, p = 0.57).ConclusionsPerioperative milrinone infusion improved the mortality after the Norwood-Sano procedure. Potential advantages of milrinone compared with epinephrine are fewer arrhythmias and better systemic perfusion, which could decrease lethal cardiac events in the ICU.Copyright © 2021 Elsevier Inc. All rights reserved.

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