Experiences of levosimendan as an inotropic agent in conjunction with passive containment surgery

Objectives. Levosimendan is a calcium sensitizer with a positive inotropic effect without increasing oxygen consumption. We have evaluated the immediate effects of levosimendan on cardiac index when given peri-operatively to patients with dilated cardiomyopathy in conjunction with passive containment surgery. Design. Ten patients with dilated cardiomyopathy undergoing passive containment surgery with the ACORN Cardiac Support Device, either as the sole procedure or in combination with other open heart surgery, were after anaesthesia induction given levosimendan as a bolus dose of 12 mu g/kg followed by an infusion of 0.1 mu g/kg/min for 24 hours. Cardiac index were measured before extra corporal circulation, immediately after extra corporal circulation, at arrival to the intensive care unit and on post operative day 1. The need for inotropic support was recorded. Results. Nine of ten patients were preoperatively in a low cardiac output situation. At postoperative day 1 there was a significant increase in cardiac index from 2.1 +/- 0.1 to 2.8 +/- 0.2. Conclusions. This study confirms the theoretical benefits of levosimendan judged by an immediate significant positive effect on cardiac index.