The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery

被引:2
|
作者
Leivaditis, Vasileios [1 ]
Grapatsas, Konstantinos [2 ]
Papaporfyriou, Anastasia [3 ]
Galanis, Michail [4 ]
Koletsis, Efstratios [5 ]
Charokopos, Nikolaos [5 ]
Haussmann, Erich [1 ]
Kaplunov, Vladislav [1 ]
Papatriantafyllou, Athanasios [6 ]
Dahm, Manfred [1 ]
机构
[1] Westpfalz Klinikum, Dept Cardiothorac & Vasc Surg, D-67655 Kaiserslautern, Germany
[2] Univ Duisburg Essen, Univ Hosp Essen, West German Lung Ctr, Dept Thorac Surg & Thorac Endoscopy,Ruhrlandklin, D-45239 Essen, Germany
[3] Vienna Univ Hosp, Dept Pulmonol, Internal Med 2, A-1090 Vienna, Austria
[4] Univ Bern, Bern Univ Hosp, Inselspital, Dept Thorac Surg, CH-3012 Bern, Switzerland
[5] Univ Hosp Patras, Dept Cardiothorac Surg, Patras 26504, Greece
[6] Gen Hosp Patras Agios Andreas, Dept Gen Surg, Patras 26332, Greece
关键词
levosimendan; heart failure; cardiac surgery; myocardial injury; angina pectoris; LEFT-VENTRICULAR DYSFUNCTION; ATRIAL-FIBRILLATION; LUNG INJURY; METAANALYSIS; MORTALITY; TERM;
D O I
10.3390/jcdd10080332
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Postoperative myocardial dysfunction following cardiac surgery is a relatively common occurrence. Levosimendan, a calcium sensitizer and inotropic drug, has shown potential in improving outcomes for patients with low preoperative ejection fraction (EF) and myocardial dysfunction after cardiac surgery. This study aims to evaluate the efficacy of levosimendan in optimizing the surgical outcome for such patients. Methods: A retrospective analysis was conducted on 314 patients with preoperative severe heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while a comparable group of 130 patients received conventional treatment. Results: The use of levosimendan demonstrated several advantages in postoperative outcomes. It significantly improved short- and long-term survival rates after cardiac surgery, enhanced hemodynamic stability, reduced the requirement for inotropic support, and facilitated faster weaning from ventilator support. Patients who received levosimendan reported reduced angina and dyspnea symptoms, as well as fewer postoperative arrhythmias. Furthermore, levosimendan helped minimize myocardial injury inevitable after cardiac surgery. The levosimendan group also exhibited a notable reduction in hospital readmissions. Conclusions: This study provides evidence of several benefits associated with the perioperative use of levosimendan. However, further prospective randomized studies are warranted to standardize and comprehensively document the other perioperative therapies, in order to validate these findings and establish stronger conclusions.
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页数:18
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