beraprost and Mitral-Valve-Insufficiency

A 33-year-old-man had severe secondary pulmonary hypertension due to perivalvular leakage at the aortic and mitral positions after aortic and mitral valve replacement. Preoperative cardiac catheterization revealed pulmonary artery pressure of 105/45 mmHg and pulmonary vascular resistance of 929 dynes.s.cm(-5) To save the patient, we performed aortic and mitral valve re-replacement, and tricuspid annuloplasty. After surgery, selective pulmonary vasodilators, beraprost sodium, inhaled nitric oxide, and intravenous prostaglandin (PG) I(2) were administered because of persistent severe pulmonary hypertension. Cardiac catheterization on postoperative day 58 showed that the pulmonary artery pressure and pulmonary vascular resistance had decreased to 40/20 mmHg and 87.7 dynes x s x cm(-5), respectively The simultaneous use of inhaled nitric oxide, intravenous PGI(2), and oral beraprost sodium might be useful for treating postoperative persistent pulmonary hypertension.

Topics: Administration, Inhalation; Administration, Oral; Adult; Antihypertensive Agents; Aortic Valve Insufficiency; Blood Pressure; Cardiac Catheterization; Combined Modality Therapy; Device Removal; Drug Therapy, Combination; Epoprostenol; Heart Valve Prosthesis Implantation; Humans; Hypertension, Pulmonary; Infusions, Intravenous; Male; Mitral Valve Insufficiency; Nitric Oxide; Pulmonary Circulation; Reoperation; Severity of Illness Index; Treatment Outcome; Vascular Resistance; Vasodilator Agents