Effectiveness of prophylactic levosimendan in high-risk valve surgery patients
| Autor: | Ersoy, Ozgur, Boysan, Emre, Unal, Ertekin Utku, Yay, Kerem, Yener, Umit, Cicekcioglu, Ferit, Katircioglu, Fehmi |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Time Factors
Turkey Hypertension Pulmonary Heart Valve Diseases Pulmonary Artery Severity of Illness Index Drug Administration Schedule levosimendan pulmonary hypertension Humans Arterial Pressure Familial Primary Pulmonary Hypertension Infusions Parenteral Simendan left ventricular dysfunction Heart Valve Prosthesis Implantation Cardiopulmonary Bypass Cardiovascular Topics Hemodynamics Hydrazones Cardiovascular Agents Stroke Volume Pyridazines Treatment Outcome cardiac valve Vascular Resistance cardiac surgery |
| Zdroj: | Cardiovascular Journal of Africa |
| ISSN: | 1680-0745 1995-1892 |
| 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 (< 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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