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Ann Thorac Surg 1996;61:1051-1052
© 1996 The Society of Thoracic Surgeons
Department of Surgery, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| The first 20% of the full text of this article appears below. |
The study by Fullerton and associates [1] published in this issue of The Annals represents a significant step forward in the management of right heart failure. This clinical problem has vexed cardiac surgeons for decades, initially in the setting of operations for advanced mitral valve disease, after embolectomy for acute pulmonary embolism, and after certain operations for congenital heart disease. In recent decades, right heart failure has been recognized as a significant source of morbidity and mortality after heart transplantation, and after the institution of left ventricular mechanical assistance. Techniques to manage this often difficult problem can greatly benefit these clinical areas.
The traditional therapeutic strategies for managing right heart failure have focused on the use of various agents that decrease pulmonary vascular resistance and therefore, right heart afterload. However, until recently, vasodilator agents used to treat right heart failure were nonspecific; that is, agents such as tolazoline, nitroprusside, or nitroglycerin dilate not only the
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