Takeno Masayoshi, Takagi Shuichi, Sakuragi Satoru, Suzuki Shoji, Tsutsumi Yoshiaki, Nonogi Hiroshi, Goto Yoichi
Division of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita 565-8565, Japan.
Heart Vessels. 2002 Nov;17(1):42-4. doi: 10.1007/s003800200041.
We report a 48-year-old man with inflammatory aortic aneurysm in the ascending aorta complicating severe heart failure due to massive aortic regurgitation. Continuous intravenous milrinone infusion was highly effective in reducing pulmonary arterial pressure and improving subjective symptoms during preoperative anti-inflammatory corticosteroid therapy over 7 weeks without any adverse effects or tolerance. Bentall's operation with a valved conduit was successfully performed after complete stabilization of inflammatory markers, and then milrinone was tapered off uneventfully. We consider that continuous milrinone infusion may be suitable for patients with surgically correctable inflammatory cardiovascular diseases complicating severe heart failure in whom maintenance of optimal hemodynamics is necessary for several weeks during preoperative anti-inflammatory corticosteroid therapy.
我们报告了一名48岁男性，其升主动脉存在炎性动脉瘤，并发严重心力衰竭，原因是大量主动脉瓣反流。在为期7周的术前抗炎皮质类固醇治疗期间，持续静脉输注米力农在降低肺动脉压和改善主观症状方面非常有效，且无任何不良反应或耐受性问题。在炎症指标完全稳定后，成功进行了带瓣管道的Bentall手术，随后米力农顺利减量。我们认为，对于术前抗炎皮质类固醇治疗期间需要数周维持最佳血流动力学的、患有可手术矫正的炎性心血管疾病并发严重心力衰竭的患者，持续输注米力农可能是合适的。
