[The step to improve the operative outcome in patients with severe valvular heart disease].

In an effort to improve the operative outcome in severe valvular heart disease, we investigated the effects of low-dose infusion of dopamine and dobutamine up to the day of operation. New York Heart Association Functional Class was improved significantly before operation, as compared with at the time of admission. It was possible to perform operation on individual patients when their physical condition seemed to be at their best. In patients with fear of postoperative renal failure, hemodialysis was combined during cardiac surgery to prevent failing to renal dysfunction after operation. As the result of these procedures, we were able to obtain satisfactory result. In patients with severe valvular heart disease, the preoperative combined infusion of dopamine and dobutamine, and hemodialysis during cardiac surgery to prevent postoperative renal dysfunction seemed to improve the operative outcome.