Separation from cardiopulmonary bypass in a nitric oxide non-responder using inhaled nitroglycerin

ABSTRACT

Nitric oxide (NO) inhalation has been used after mitral valve surgery in attempts to control pulmonary hypertension. The cost of NO therapy in some countries has made its use prohibitive and has led to attempts to use aerosolized nitroglycerin. This therapeutic approach may have a place, not only where NO use is a financial hardship, but also as a bridge to, or in lieu of, other traditional therapies for pulmonary hypertension, especially in NO non-responders. Presented here is a case in which aerosolized nitroglycerin was used to separate a NO non-responder with severe pulmonary hypertension and elevated right heart pressures from cardiopulmonary bypass (CPB), his second of two surgeries in a 96 hour period.