Preoperative Examination Findings for Prediction of Use of Inotropic Agents at Weaning from Cardiopulmonary Bypass

Object: Postoperative left ventricular dysfunction often occurs after cardiopulmonary bypass(CPB), requiring inotropic drug administration to achieve adequate hemodynamic status. The purpose of our study was to determine whether preoperative examination findings can predict the use of inotropic agents at separation from CPB in patients undergoing mitral valve repair without preoperative heart failure. Methods: Patients who underwent a mitral valve repair procedure between November 2009 and November 2010 were studied. Inotropic support was defined as use of milrinone at separation from CPB, and was implemented as clinically indicated. Echocardiography and laboratory data before surgery were retrospectively examined and compared between the patients who require inotropic support(Group M) and who did not(Group C). Results: We analyzed 33 patients who underwent a mitral valve repair procedure, 14 of whom required inotropic support. There were no significant differences in CPB time and cross clamp time, and no differences in contraction or diastolic function shown by echocardiography. However, NT pro-BNP in Group M was higher than that in Group C. Conclusion: Elevation of preoperative NT-pro BNP, irrespective of echocardiography findings, was found to be a predictor of inotropic support at separation of CPB in patients without preoperative heart failure.