Inhaled Vasodilators in Right Heart Failure

  • Mahsa Elmi-Sarabi
  • André DenaultEmail author


This chapter presents a brief description for the use of inhaled vasodilators in the management of right ventricular failure (RVF) in cardiac surgical patients. The effects of inhaled vasodilators extend beyond the right heart and pulmonary circulation and can also be seen on the portal vein and on cerebral oxygenation. Agents such as milrinone and epoprostenol, which are typically administered intravenously, can exert a more localized effect when aerosolized. In this form, these drugs can selectively lower pulmonary pressures without exhibiting a systemic effect, thus showing to be beneficial in the management of right ventricular (RV) dysfunction.

The experiences described in this chapter originate from researchers at the Montreal Heart Institute (MHI) in Quebec, Canada. The MHI is an ultraspecialized hospital centre dedicated to care, research, teaching, prevention, rehabilitation, and the assessment of new technologies in cardiology. It is affiliated with Université de Montréal.


Inhaled vasodilator Milrinone Epoprostenol Pulmonary hypertension Cardiac surgery Near-infrared spectroscopy Portal vein pulsatility 



Coronary artery bypass grafting


Cyclic adenosine monophosphate


Cyclic guanosine monophosphate


Carbon dioxide


Cardiopulmonary bypass




Intensive care unit


Left ventricular


Montreal Heart Institute


Mean pulmonary artery pressure


Near-infrared spectroscopy


Nitric oxide


Operating room


Pulmonary artery pressure




Phosphodiesterase type 3


Phosphodiesterase type 5




Pulmonary hypertension


Right ventricular pressure


Right atrial


Regional oxygen saturation


Right ventricle


Right ventricular failure


Transesophageal echocardiography


Transthoracic echocardiography


Thromboxane A2


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyMontreal Heart Institute, Université de MontréalMontrealCanada

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