[Effectiveness of adenosine as a pulmonary vasodilator during weaning from extracorporeal circulation after mitral valve replacement in a patient with severe pulmonary hypertension].

A 75-year-old woman with mitral stenosis and tricuspid insufficiency underwent mitral valve replacement surgery. After insertion of a catheter into the pulmonary artery, upper respiratory system pressure was seen to rise above systemic arterial pressure. To relax the pulmonary vessel, we administered adenosine, a drug that is metabolized rapidly during its first pass through the lungs before hypotension or other adverse side effects occur systemically. Adenosine decreased pulmonary artery pressure and vascular resistance, optimizing right cardiac function with successful output to extracorporeal circulation.