Nesiritide, a recombinant B-type natriuretic peptide used for the intravenous treatment of acute decompensated congestive heart failure. Concerns have been raised about the long-term use of nesiritide, but data is scarce regarding its use in acute congestive heart failure and during cardiac surgery. We conducted a retrospective data review to address the safety of nesiritide for pretreatment of patients undergoing mitral valve surgery.