In 223 operations of cardiovascular surgery, myocardial performance was supported, after the interruption of cardiopulmonary bypass, by means of a combined and strictly controlled administration of a pure vasodilator drug (sodium nitroprusside) and of an inotropic agent (epinephrine). The reduction of afterload achieved by the former, the increase of contractility and heart rate induced by the latter, the coronary dilator effect of both, associated with an adequate maintaining of preload proved to be rapidly effective. This appeared to be particularly true in patients with overt left ventricular failure after valve replacement and/or myocardial revascularization procedures. The proposed association of drugs and treatment program seem to be an appropriate way of managing the myocardial and hemodynamic response to the metabolic reactivation that follows the surgical ischemic cardiac arrest.