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Related Experiment Videos

Milrinone echocardiographic viability test: a pilot study.

S C Dhar1, Y Birnbaum, S Hayes

  • 1Department of Cardiothoracic Surgery, Los Angeles, Calif, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|July 12, 2001
PubMed
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Milrinone infusion effectively predicts recovery of left ventricular function after coronary artery bypass graft surgery in patients with severe systolic dysfunction. Improved function during milrinone predicts significant improvement post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pharmacology

Background:

  • Severe left ventricular systolic dysfunction in coronary artery disease (CAD) poses challenges for surgical revascularization.
  • Predicting myocardial viability is crucial for selecting appropriate candidates for coronary artery bypass graft (CABG) surgery.
  • Identifying segments likely to regain function post-CABG aids surgical planning and improves patient outcomes.

Purpose of the Study:

  • To evaluate the utility of milrinone as a predictor of functional recovery after CABG in patients with severe left ventricular systolic dysfunction.
  • To assess if milrinone-induced improvements in left ventricular function correlate with post-CABG functional recovery.

Main Methods:

  • Twenty patients with CAD and ejection fraction ≤40% underwent elective CABG.

Related Experiment Videos

  • Transesophageal echocardiography assessed left ventricular regional wall motion and global ejection fraction before and after milrinone infusion, and post-CABG.
  • Functional improvement was defined as a wall motion score change >1; milrinone's effect on akinetic/dyskinetic segments was analyzed.

    • Main Results:

    • Milrinone increased ejection fraction from 27% to 35% (P<.0001), which correlated significantly with post-CABG ejection fraction (36%, P<.0001).
    • Of 209 abnormal segments, 98 showed improved contraction with milrinone; 92.9% of these improved post-CABG.
    • Segments not improving with milrinone (98.2%) also failed to improve after revascularization; 63% of akinetic/dyskinetic segments improved with milrinone.

    Conclusions:

    • Milrinone infusion is a highly predictive tool for assessing left ventricular functional recovery after CABG in patients with ischemic cardiomyopathy.
    • Improvements in segmental wall motion and global ejection fraction during milrinone administration strongly indicate positive outcomes post-revascularization.
    • Milrinone's ability to augment contraction in dysfunctional segments effectively identifies viable myocardium that will benefit from CABG.