We report our experience with the use of
enoximone in 5 patients with severely depressed preoperative myocardial function who underwent cardiac surgery. In patients 1 and 2,
enoximone was administered as the inotropic of choice before
cardiopulmonary bypass (CPB) and a substantial improvement of cardiac index was achieved; in these patients,
enoximone administration after CPB permitted to overcome
low cardiac output which persisted after high dose
dobutamine in patient 1, and in patient 2 right ventricular contractility improved. In patient 3 the use of
enoximone permitted the discontinuation of CPB, which had not been previously possible with the association of
dopamine and
dobutamine. In this patient,
adrenaline perfusion improved the
low cardiac output syndrome but resulted in poorly tolerated side effects. However, in patient 4 the administration of
enoximone during pre-CPB did not improve in a reduction in filling pressures without an increase in the cardiac index because the patient was
hypovolemic. In patient 5, the administration of
enoximone permitted to interrupt the infusion of
dobutamine and to reduce the dose of
sodium nitroprusside, which had resulted in significant
tachycardia, with increased myocardial contractility and a reduction of vascular peripheral and pulmonary resistances. We conclude that
enoximone, single or in association with other inotropics, should be considered a
drug of choice in patients undergoing cardiac surgery who develop a
low cardiac output syndrome.