Answer 8

Immediately post-bypass, TEE shows a large amount of mitral regurgitation. This is the most likely cause of the new pulmonary hypertension, by causing high left atrial pressure and high pulmonary venous pressure. This mitral regurgitation is most likely due to left ventricular stunning or ischemia, and indicates the need for inotropic support. Thus, answer 2 or 3 would be most likely. The combination of milrinone and epinephrine would produce a more potent inotropic effect than epinephrine alone.