Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery

• Published in: Interactive cardiovascular and thoracic surgery Vol. 5; no. 3; pp. 322 - 326
• Main Authors: Tokuda, Yoshiyuki, Grant, Peter W, Wolfenden, Hugh D, Manganas, Con, Lyon, William J, Murala, John S.K
• Format: Journal Article
• Language: English
• Published: England Eur Assoc Cardio Surg 01.06.2006
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2005.122390

Department of Cardiothoracic Surgery, Prince of Wales Hospital, Barker Street, Randwick, New South Wales, 2031, Australia *Corresponding author. Tel.: +61-2-9382-0490; fax: +61-2-93820493. E-mail address : tokuda{at}mxb.mesh.ne.jp (Y. Tokuda). The efficacy of levosimendan treatment for a low cardiac output status following cardiac surgery has not been established. Here, we review our initial experiences of the perioperative use of levosimendan. This study is a retrospective uncontrolled trial. Nine patients who underwent cardiac surgery, and developed a low cardiac output status resistant to conventional inotropic support, were given levosimendan. The mean preoperative ejection fraction was 35.2±3.4%. All patients were on concomitant inotropic agents and had previously undergone intra-aortic balloon pumping. Cardiac index increased immediately from 2.14±0.33 l/min/m 2 at baseline to 2.41±0.31 ( P =0.02) at 1 h, rising to 2.67±0.43 ( P <0.001) at 4 h after the loading dose was started. Similarly, the systemic vascular resistance index decreased from 2350±525 dynes/s/cm –5 /m 2 at baseline to 1774±360 ( P =0.002) at 4 h. In the case of all but one of the patients, either the dose of the concomitant inotropic support or the balloon pumping could be weaned down within 24 h after completion of the levosimendan infusion. No withdrawal of levosimendan was required. Levosimendan could constitute a new therapeutic option for postoperative low cardiac output. Key Words: Levosimendan; Postoperative care; Impaired ventricular function Related Articles ICVTS on-line discussion A Mohamed Fahmy Ibrahim Interactive CardioVascular and Thoracic Surgery 2006 5: 326. [Full Text] [PDF] ICVTS on-line discussion B Alexander Wahba Interactive CardioVascular and Thoracic Surgery 2006 5: 326. [Full Text] [PDF]