Postoperative nesiritide use following high-risk mitral valve replacement.

Nesiritide is primarily used in the treatment of acutely decompensated chronic heart failure. It may also be useful in the postoperative management of patients with an exacerbation of heart failure after cardiac surgery. The management of a patient with cardiogenic shock after acute papillary muscle rupture is described. The patient exhibited signs of postoperative heart failure, and nesiritide therapy was instituted to lower filling pressures and achieve diuresis. This drug may be useful when patients with heart failure undergo cardiac surgery and continue to show evidence of heart failure in the postoperative period.