Preoperative levosimendan in ischemic mitral valve repair.

Pranav Sharma, Amber Malhotra, Sanjay Gandhi, Pankaj Garg, Arvind Bishnoi, Hemang Gandhi

Journal: Asian cardiovascular & thoracic annals 2017;22(5):539-45

PMID: 24867027

Abstract

BACKGROUND

Levosimendan is a new calcium sensitizing drug with vasodilatory and inotropic properties, which is used for the treatment of postoperative low cardiac output syndrome and difficult weaning from cardiopulmonary bypass.

OBJECTIVE

To evaluate the hemodynamic effects of levosimendan during and after coronary artery bypass grafting on cardiopulmonary bypass and mitral valve repair in patients with low left ventricular ejection fractions (<30%).

METHODS

40 patients were enrolled in this double-blind prospective randomized controlled trial. They received either levosimendan or a placebo preoperatively (n = 20) for 24 h. Clinical parameters were measured before and after administration. Any adverse events during and after drug administration and postoperative complications were evaluated.

RESULTS

Patients treated with levosimendan exhibited a higher cardiac index and mean arterial pressure intraoperative and in the early postoperative period, compared to the control group. Patients treated with levosimendan required less ventilatory support (p < 0.0001) and had shorter intensive care unit (p < 0.0001) and hospital stay (p < 0.0001).

CONCLUSIONS

Preoperative treatment with levosimendan in patients undergoing coronary artery bypass grafting and mitral valve repair resulted in improved hemodynamics and a stable postoperative course.

Address: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India [email protected].; UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.

DOI: 10.1177/0218492313499352

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MeSH Terms: Adult, Aged, Cardiopulmonary Bypass, Cardiotonic Agents, Coronary Artery Bypass, Coronary Artery Disease, Double-Blind Method, Female, Heart Valve Prosthesis Implantation, Hemodynamics, Humans, Hydrazones, India, Intensive Care Units, Length of Stay, Male, Middle Aged, Mitral Valve Annuloplasty, Mitral Valve Insufficiency, Postoperative Complications, Preoperative Care, Prospective Studies, Pyridazines, Respiration, Artificial, Simendan, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left, Ventricular Function, Left