Effectiveness of prophylactic levosimendan in high-risk valve surgery patients : cardiovascular topics
| Autor: | Kerem Yay, Fehmi Katircioglu, Ertekin Utku Ünal, Umit Yener, Ozgur Ersoy, Emre Boysan, Ferit Cicekcioglu |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Cardiac output Ejection fraction business.industry Cardiac index Hemodynamics General Medicine Levosimendan law.invention medicine.anatomical_structure law medicine.artery Anesthesia Internal medicine Pulmonary artery Vascular resistance Cardiopulmonary bypass Cardiology Medicine Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Cardiovascular Journal Of Africa. 24:260-264 |
| ISSN: | 1680-0745 1995-1892 |
| DOI: | 10.5830/cvja-2013-047 |
| Popis: | Background : Levosimendan has anti-ischaemic effects, improves myocardial contractility and increases systemic, pulmonary and coronary vasodilatation. These properties suggest potential advantages in high-risk cardiac valve surgery patients where cardioprotection would be valuable. The present study investigated the peri-operative haemodynamic effects of prophylactic levosimendan infusion in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension. Methods : Between May 2006 and July 2007, 20 consecutive patients with severe pulmonary arterial hypertension (systolic pulmonary artery pressure ≥ 60 mmHg) and/or low ejection fraction (l 50%) who underwent valve surgery in our clinic were included in the study and randomised into two groups. Levosimendan was administered to 10 patients in group I and not to the 10 patients in the control group. Cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR) and mean pulmonary artery pressure (MPAP) were recorded for each patient preoperatively and for 24 hours following the operation. Results : CO and CI values were higher in the levosimendan group during the study period (p < 0.05). MPAP and PVR values were significantly lower in the levosimendan group for the 24-hour period (p < 0.05) and SVR values were significantly lower after 24 hours in both groups. When clinical results were considered, no difference in favour of levosimendan was detected regarding the mortality and morbidity rates between the groups. Conclusion : Levosimendan improved the haemodynamics in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension, and facilitated weaning from cardiopulmonary bypass in such high-risk patients when started as a prophylactic agent. |
| Databáze: | OpenAIRE |
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