Which medication is preferred to support right ventricular output while lowering pulmonary artery pressures?

Milrinone is preferred for supporting right ventricular output and lowering pulmonary artery pressures due to its unique properties as a phosphodiesterase-3 (PDE3) inhibitor. This medication leads to increased levels of cyclic AMP within the cardiac muscle, resulting in enhanced myocardial contractility and vasodilation. These effects can significantly improve cardiac output, particularly in patients with heart failure who have right ventricular dysfunction.

Moreover, milrinone specifically aids in the reduction of pulmonary artery pressures through its vasodilatory effects on the pulmonary vasculature. This can be particularly beneficial in conditions such as pulmonary hypertension where lowering these pressures is crucial. The balance of inotropic support and pulmonary vasodilation provided by milrinone makes it an effective choice in these clinical scenarios.

Other choices may offer some degree of inotropic support but lack the targeted vasodilatory effect on pulmonary arteries that milrinone provides, making them less suitable in this particular context.