Pre-operative use of levosimendan in two patients with severe aortic stenosis and left ventricular dysfunction.
We describe two patients with severe aortic stenosis, coronary artery disease, severe left ventricular dysfunction and heart failure in which the calcium-sensitising agent, levosimendan was administered prior to aortic valve replacement and coronary artery bypass graft surgery. In both cases, drug infusion was well tolerated at the doses used, heart failure improved significantly prior to surgery and peri-operative management was relatively uncomplicated in cases that would traditionally be considered high risk. Further investigation of the use of levosimendan both for treating heart failure in the presence of severe aortic stenosis and as pre-operative therapy is warranted.
Prior
David L
DL
Cardiac Investigation Unit, St Vincent's Hospital, Melbourne, P.O. Box 2900, Fitzroy, Vic. 3065, Australia. priordl@svhm.org.au
Flaim
Brendan D
BD
MacIsaac
Andrew I
AI
Yii
Michael Y
MY
D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy*
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan