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levosimendan cardiac surgery

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https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#1
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#2
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#3
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27801307/pregnancy-related-cardiovascular-complications-case-presentation-and-review-of-literature
#4
Hasan Baki Altinsoy, Ozkan Alatas, Salih Colak, Hakan Atalay, Omer Faruk Dogan
BACKGROUND: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. METHODS: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27801303/levosimendan-use-increases-cardiac-performance-after-coronary-artery-bypass-grafting-in-end-stage-renal-disease-patients
#5
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27720291/impact-of-milrinone-administration-in-adult-cardiac-surgery-patients-updated-meta-analysis
#6
Masahiro Ushio, Moritoki Egi, Junji Wakabayashi, Taichi Nishimura, Yuji Miyatake, Norihiko Obata, Satoshi Mizobuchi
OBJECTIVE: To determine the effects of milrinone on short-term mortality in cardiac surgery patients with focus on the presence or absence of heterogeneity of the effect. DESIGN: A systematic review and meta-analysis. SETTING AND PARTICIPANTS: Five hundred thirty-seven adult cardiac surgery patients from 12 RCTs. INTERVENTIONS: Milrinone administration. MEASUREMENTS AND MAIN RESULTS: The authors conducted a systematic Medline and Pubmed search to assess the effect of milrinone on short-term mortality in adult cardiac surgery patients...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27703584/the-role-of-levosimendan-in-patients-with-decreased-left-ventricular-function-undergoing-cardiac-surgery
#7
Marija Bozhinovska, Gordana Taleska, Andrej Fabian, Maja Šoštarič
The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27684548/levosimendan-administration-in-limb-ischemia-multicomponent-signaling-serving-kidney-protection
#8
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
https://www.readbyqxmd.com/read/27583039/the-effects-of-levosimendan-and-sodium-nitroprusside-combination-on-left-ventricular-functions-after-surgical-ventricular-reconstruction-in-coronary-artery-bypass-grafting-patients
#9
Zeki Temizturk, Davut Azboy, Atakan Atalay, Hakan Atalay, Omer Faruk Dogan
OBJECTIVE: The aim of our study was to research the effects of levosimendan (LS) and sodium nitroprusside (SNP) combination on systolic and diastolic ventricular function after coronary artery bypass grafting (CABG) who required endoventricular patch repair (EVPR). PATIENTS AND METHODS: We studied 70 patients with ischemic dilated cardiomyopathy. LS and SNP combination was administered in 35 patients (study group, SG). In the remaining patients, normal saline solution was given (placebo group, PG)...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27518430/preoperative-optimization-with-levosimendan-in-heart-failure-patient-undergoing-thoracic-surgery
#10
Moana Rossella Nespoli, Marco Rispoli, Dario Maria Mattiacci, Marianna Esposito, Antonio Corcione, Carlo Curcio, Salvatore Buono
INTRODUCTION: We present the case of a patient with dilatative cardiomyopathy waiting for heart transplantation with pleural effusion to be subjected to pleural biopsy, treated with preoperative infusion of levosimendan to improve heart performances. PRESENTATION OF CASE: A 56-year-old man (BMI 22,49) with dilatative cardiomyopathy (EF 18%) presented right pleural effusion. The levosimendan treatment protocol consisted of 24h continuous infusion (0,1ug/kg/min), without bolus...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27500723/inotropic-therapy-in-newborns-a-population-based-national-registry-study
#11
Margrete Larsen Burns, Hans Jørgen Stensvold, Kari Risnes, Hans Jørgen Guthe, Henriette Astrup, S Marianne Nordhov, Terje Reidar Selberg, Arild Rønnestad, Astri Maria Lang
OBJECTIVE: To describe the use of inotropic drugs and the characteristics of neonates receiving such treatment in a national cohort of patients admitted to neonatal ICUs in Norway. DESIGN: A national registry study of patients included in the Norwegian Neonatal Network database 2009-2014. Demographic and treatment data, including the use of inotropic drugs (dopamine, dobutamine, epinephrine, norepinephrine, milrinone, and levosimendan) and outcomes, were retrieved and analyzed...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27378790/effectiveness-of-prophylactic-levosimendan-in-patients-with-impaired-left-ventricular-function-undergoing-coronary-artery-bypass-grafting-a-randomized-pilot-study
#12
Kyriakos Anastasiadis, Polychronis Antonitsis, Konstantinos Vranis, Athanassios Kleontas, Christos Asteriou, Vassilios Grosomanidis, Paschalis Tossios, Helena Argiriadou
OBJECTIVES: Perioperative low cardiac output syndrome occurs in 3-14% of patients undergoing isolated coronary artery bypass grafting (CABG), leading to significant increase in major morbidity and mortality. Considering the unique pharmacological and pharmacokinetic properties of levosimendan, we conducted a prospective, double-blind, randomized pilot study to evaluate the effectiveness of prophylactic levosimendan in patients with impaired left ventricular function undergoing CABG. METHODS: Thirty-two patients undergoing CABG with low left ventricular ejection fraction (LVEF ≤ 40%) were randomized to receive either a continuous infusion of levosimendan at a dose of 0...
November 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27369103/-use-of-levosimendan-in-children
#13
P-E Séguéla, N Tafer, J-B Thambo, P Mauriat
Levosimendan is a calcium-sensitizing drug with positive inotropic properties. As an inodilator, this molecule also has a vasodilation effect. While its efficacy has been demonstrated in the adult in the context of cardiac surgery, its pediatric use is still not widespread. Many studies have shown its safety of use in children, including in the newborn. Across the world, a growing number of teams use levosimendan to treat both acute and chronic heart failure. Through a review of the literature, we describe its pharmacodynamic effects, its current applications, and its perspectives of use in children...
August 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27321790/comparative-effect-of-levosimendan-and-milrinone-in-cardiac-surgery-patients-with-pulmonary-hypertension-and-left-ventricular-dysfunction
#14
Abhi Mishra, Bhupesh Kumar, Vikas Dutta, V K Arya, Anand Kumar Mishra
OBJECTIVE: To compare the effects of levosimendan with milrinone in cardiac surgical patients with pulmonary hypertension and left ventricular dysfunction. DESIGN: A prospective, randomized study. SETTING: Tertiary care teaching hospital. PARTICIPANTS: The study included patients with valvular heart disease and pulmonary artery hypertension undergoing valve surgery. INTERVENTIONS: Forty patients were allocated randomly to receive either milrinone, 50 µg/kg bolus followed by infusion at a rate of 0...
June 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27297851/a-randomized-controlled-trial-of-levosimendan-to-reduce-mortality-in-high-risk-cardiac-surgery-patients-cheetah-rationale-and-design
#15
Alberto Zangrillo, Gabriele Alvaro, Antonio Pisano, Fabio Guarracino, Rosetta Lobreglio, Nikola Bradic, Rosalba Lembo, Stefano Gianni, Maria Grazia Calabrò, Valery Likhvantsev, Evgeny Grigoryev, Giuseppe Buscaglia, Giovanni Pala, Elisabetta Auci, Bruno Amantea, Fabrizio Monaco, Giovanni De Vuono, Antonio Corcione, Nicola Galdieri, Claudia Cariello, Tiziana Bove, Evgeny Fominskiy, Stefano Auriemma, Massimo Baiocchi, Alessandro Bianchi, Mario Frontini, Gianluca Paternoster, Fabio Sangalli, Chew-Yin Wang, Maria Chiara Zucchetti, Giuseppe Biondi-Zoccai, Marco Gemma, Michael J Lipinski, Vladimir V Lomivorotov, Giovanni Landoni
OBJECTIVE: Patients undergoing cardiac surgery are at risk of perioperative low cardiac output syndrome due to postoperative myocardial dysfunction. Myocardial dysfunction in patients undergoing cardiac surgery is a potential indication for the use of levosimendan, a calcium sensitizer with 3 beneficial cardiovascular effects (inotropic, vasodilatory, and anti-inflammatory), which appears effective in improving clinically relevant outcomes. DESIGN: Double-blind, placebo-controlled, multicenter randomized trial...
July 2016: American Heart Journal
https://www.readbyqxmd.com/read/27168089/levosimendan-new-indications-and-evidence-for-reduction-in-perioperative-mortality
#16
Antonio Pisano, Giacomo Monti, Giovanni Landoni
PURPOSE OF REVIEW: In the last years, the perioperative use of levosimendan in cardiac surgery patients is spreading. Moreover, newer indications have been suggested such as the treatment of sepsis-associated myocardial dysfunction. In the present review, we discuss the most recent evidences in these settings. RECENT FINDINGS: Levosimendan has been seemingly confirmed to reduce mortality in patients undergoing cardiac surgery. In particular, it appears to be the only inotropic drug to have a favorable effect on survival in any clinical setting...
August 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27143905/cardiac-renal-and-neurological-benefits-of-preoperative-levosimendan-administration-in-patients-with-right-ventricular-dysfunction-and-pulmonary-hypertension-undergoing-cardiac-surgery-evaluation-with-two-biomarkers-neutrophil-gelatinase-associated-lipocalin
#17
José Luis Guerrero-Orriach, Daniel Ariza-Villanueva, Ana Florez-Vela, Lourdes Garrido-Sánchez, María Isabel Moreno-Cortés, Manuel Galán-Ortega, Alicia Ramírez-Fernández, Juan Alcaide Torres, Concepción Santiago Fernandez, Isabel Navarro Arce, José María Melero-Tejedor, Manuel Rubio-Navarro, José Cruz-Mañas
PURPOSE: To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. METHODS: This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27011685/successful-use-of-levosimendan-as-a-primary-inotrope-in-pediatric-cardiac-surgery-an-observational-study-in-110-patients
#18
Reena Khantwal Joshi, Neeraj Aggarwal, Mridul Aggarwal, Rakesh Pandey, Veronique Dinand, Raja Joshi
CONTEXT: Levosimendan is a new generation inotrope with calcium sensitizing properties and proven benefits in adults. AIMS: This study investigates the use of levosimendan as a first line inotrope in congenital heart surgery. SETTINGS AND DESIGN: Prospective, observational study in a tertiary care center. MATERIALS AND METHODS: One hundred and ten patients undergoing congenital cardiac surgery received levosimendan at a loading dose of 12 mcg/kg during rewarming on cardiopulmonary bypass followed by continuous infusion of 0...
January 2016: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/26977768/five-year-mortality-in-cardiac-surgery-patients-with-low-cardiac-output-syndrome-treated-with-levosimendan-prognostic-evaluation-of-nt-probnp-and-c-reactive-protein
#19
Herminia Torrado, Juan C Lopez-Delgado, Elisabet Farrero, David Rodríguez-Castro, María J Castro, Elisabet Periche, Maria L Carriò, Jacobo E Toscano, Alain Pinseau, Casimiro Javierre, Josep L Ventura
BACKGROUND: To determine the clinical risk factors predictive of the 5-year mortality in patients with low cardiac output syndrome (LCOS) after cardiac surgery. In addition, to assess the influence of inflammation and myocardial dysfunction severity, as measured by C-reactive protein (CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, on outcome. METHODS: We studied 30 patients who underwent cardiac surgery and developed postoperative LCOS requiring inotropic support for longer than 48 hours after intensive care unit (ICU) admission...
April 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/26882190/levosimendan-meta-analyses-is-there-a-pattern-in-the-effect-on-mortality
#20
REVIEW
P Pollesello, J Parissis, M Kivikko, V-P Harjola
BACKGROUND: Levosimendan is an inodilator developed for treatment of acute heart failure and other cardiac conditions where the use of an inodilator is considered appropriate. Levosimendan has been studied in different therapeutic settings including acutely decompensated chronic heart failure, advanced heart failure, right ventricular failure, cardiogenic shock, septic shock, and cardiac and non-cardiac surgery. This variety of data has been re-analysed in 25 meta-analyses from 15 different international research groups, based on different rationales to select the studies included...
April 15, 2016: International Journal of Cardiology
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