[Intravenous arginine vasopressin for two pediatric cases of pulmonary hypertension after congenital heart surgery].

We experienced two pediatric cases of severe pulmonary hypertension after congenital heart surgery. It was difficult to wean two cases from cardiopulmonary bypass for systemic hypotension concomitant with pulmonary hypertension reflactory to conventional therapy, including administration of adrenaline, nitroglycerin, milrinone, and/or inhalation of nitric oxide. In order to increase systemic arterial blood pressure and improve severe right heart failure, we administered arginine vasopressin (AVP) intravenously, which is a potent vasoconstrictor via V1 receptor. The dose of AVP was 0.0002 unit x kg(-1) x min(-1). After administration of AVP, systemic arterial pressure increased markedly and pulmonary arterial pressure decreased slightly, and we succeeded in weaning the patients from cardiopulmonary bypass. No adverse effect with AVP was found. In conclusion, administration of AVP is a therapeutic option for treating systemic hypotension concomitant with severe pulmonary hypertension in pediatric congenital heart surgery.