Nesiritide is a recombinant brain-type natriuretic peptide (BNP), which decreases pulmonary arterial (PA) pressures and myocardial oxygen consumption while increasing coronary flow and urine output. Mitral valve (MV) surgery in patients with severe mitralregurgitation (MR), impaired left ventricular function, and pulmonary hypertension is associated with a high operative mortality. We hypothesized that the perioperative use of Nesiritide is safe, and may improve surgical outcomes.
Perioperative use of Nesiritide is safe, and may contribute to improved early outcomes in high-risk patients undergoing MV surgery. This may be due to improved ventricular loading conditions (decreased PA pressures, more effective diuresis) and/or a direct myocardial effect of BNP. Further prospective evaluation of the role of BNP in cardiac surgery is warranted.
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Direct access hybrid transatrial implantation of a Sapien 3 valve inside a bioprosthetic mitral valve with concomitant tricuspid valve replacement and cryoablationSophia L. Alexis, Gilbert H. L. Tang, Dimosthenis Pandis, David H. Adams, Ahmed El-Eshmawi
- Elbert E Williams, Ismail El-Hamamsy