Cc. Canver et J. Chanda, Milrinone for long-term pharmacologic support of the status 1 heart transplant candidates, ANN THORAC, 69(6), 2000, pp. 1823-1826
Citations number
20
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. We determined the efficacy of long-term therapy with milrinone
alone or in combination with inotropic agents in status 1 heart transplant
candidates as a pharmacological support until heart transplantation.
Methods. Hemodynamic and biochemical variables were recorded in 29 status 1
men with symptoms of severe congestive heart failure, who received continu
ous intravenous milrinone alone (group 1, n = 21) or in combination with in
otropic agents (group 2, n = 8) while awaiting heart transplantation.
Results. Symptomatic relief was noted in all patients of both groups withou
t any preoperative deaths. One patient (4.8%) of group 1 died on the second
day and I patient of group 2 died 16.4 months after transplantation. Altho
ugh pulmonary capillary wedge pressure (group 1, p = 0.021; group 2, p = 0.
0002), mean pulmonary artery pressure (group 1, p = 0.051; group 2, p = 0.0
04), and pulmonary vascular resistance (group 1, p = 0.0026; group 2, p = 0
.056) were reduced by 1 hour after the onset of treatment and maintained un
changed until transplantation, the changes in mean pulmonary artery pressur
e in group 1 and pulmonary vascular resistance in group 2 were statisticall
y insignificant except in the posttransplantation period.
Conclusions. Long-term therapy with milrinone in combination with inotropic
agents is safe and effective when only milrinone infusion is inadequate fo
r pharmacologic support in status 1 candidates. (C) 2000 by The Society of
Thoracic Surgeons.