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J Thorac Cardiovasc Surg 2002;124:642
© 2002 The American Association for Thoracic Surgery

Letters to the Editor

Reply

Shahrokh Taghavi, MD, Michael Grimm, MD

Department of Cardio-Thoracic Surgery, General Hospital Vienna, Vienna, Austria

Reply to the Editor:

We appreciate the interest of van der Linden, Albåge, and Dellgren in our recent article.Go 1 The authors comment on the use of a megadose of milrinone as an alternative to extracorporeal membrane oxygenation for graft failure early after heart transplantation. They present the case of a 60-year-old woman in whom biventricular failure developed after transplantation; she was treated successfully with a megadose of milrinone initially followed by a high-dose infusion of milrinone plus norepinephrine to overcome the induced systemic hypotension.

We present in our articleGo 1 the possibility of inserting an extracorporeal membrane oxygenator as a means of circulatory support for graft failure after unsuccessful conservative treatment including milrinone. Because our article was a brief communication, space was limited. It was not our intention to dismiss the importance of inotropic drugs and vasodilators with different degrees of benefits and side effects, as well as variable results. However, if drug administration does not result in cardiac improvement, we believe it is very important to implement extracorporeal membrane oxygenation early enough to avoid significant, potentially irreversible graft injury.

12/8/125484

Reference

  1. Taghavi S, Ankersmit J, Wieselthaler G, Gorlitzer M, Rajek A, Wolner E, et al. Extracorporeal membrane oxygenation for graft failure after heart transplantation: recent Vienna experience. J Thorac Cardiovasc Surg. 2001;122:819-20.[Free Full Text]




This Article
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Right arrow Email this article to a friend
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Michael Grimm
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Right arrow Articles by Grimm, M.
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PubMed
Right arrow Articles by Taghavi, S.
Right arrow Articles by Grimm, M.
Related Collections
Right arrow Cardiac - pharmacology
Right arrow Transplantation - heart

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