AMRINONE THERAPY FOR SEVERE PULMONARY-HYPERTENSION AND BIVENTRICULAR FAILURE AFTER COMPLICATED VALVULAR HEART-SURGERY

We report two cases in which amrinone was used effectively, in additio n to the conventional sympathomimetic drug, for the emergence from car diopulmonary bypass following complicated valvular heart surgery in pa tients who had severe pulmonary hypertension and biventricular failure . Amrinone was used in combination with isoproterenol in one and dopam ine 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 p ulmonary vascular resistance, respectively. Concomitantly, the mean sy stemic 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 pulmo nary hypertension not responding to conventional beta-adrenergic and v asodilator drug therapy.