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Case Reports
Effects of milrinone for right ventricular failure after left ventricular assist device implantation.
- Shin'ichiro Kihara, Akihiko Kawai, Takuya Fukuda, Noboru Yamamoto, Shigeyuki Aomi, Hiroshi Nishida, Masahiro Endo, and Hitoshi Koyanagi.
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University. kiharas@msx.upmc.edu
- Heart Vessels. 2002 Jan 1;16(2):69-71.
AbstractRight ventricular failure after left ventricular assist device implantation sometimes requires additional mechanical right ventricular support. The effectiveness of nitrates, prostaglandin, or nitric oxide inhalation in such cases has already been reported. However, there are few reports on the administration of phosphodiesterase inhibitor for right ventricular failure after left ventricular assist device implantation. We report two patients with right ventricular failure after left ventricular assist device implantation successfully treated with milrinone. Both had residual pulmonary hypertension due to high pulmonary vascular resistance after left ventricular assist device implantation. However, intravenous milrinone caused a significant reduction in pulmonary vascular resistance and an increase in left ventricular assist device flow. Milrinone acts as both an inotropic agent and a direct vasodilator, and thus may avoid the need for mechanical support for right ventricular failure due to residual pulmonary hypertension after left ventricular assist device implantation.
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