Hemodynamics Case 8

Patient with a history of coronary artery disease and hypertension to undergo coronary artery bypass grafting with left internal mammary artery. The pre-bypass LV function and PA pressures are normal. This patients is a relatively low risk case for coronary artery bypass grafting, but immediately post-bypass we have unexpectedly high pulmonary artery pressures of 60/25 mmHg. The post-bypass TEE clip below gives us a clue as to why.

The most likely drug(s) that will be needed to come off of cardiopulmonary bypass are:

1. Nitroprusside
2. Epinephrine
3. Milrinone/Epi/Vasopressin
4. Vasopressin
5. None of the above