Use of levosimendan in critically ill patients with severe aortic stenosis and left ventricular dysfunction.
Congestive heart failure and left ventricular dysfunction in the setting of severe aortic stenosis are associated with a high mortality rate. Evidence on optimal medical therapy is scanty. Vasodilators were traditionally considered to be contraindicated in severe aortic stenosis, albeit this concept has recently been challenged. The use of levosimendan, which has positive inotropic, vasodilatory and cardioprotective properties seems attractive. We describe a small series of exceedingly ill patients with severe aortic stenosis and left ventricular dysfunction, in different clinical settings (acute heart failure, cardiogenic shock and difficult-to-wean ventilatory support), in which levosimendan was successfully used.
Cardiology Department, Coimbra Hospital and University Centre, Portugal.
Francisca
F
Caetano
Paula
P
Mota
Sérgio
S
Barra
Inês
I
Almeida
Ana
A
Botelho
Joana
J
Trigo
António L
AL
Marques
Severe aortic stenosis; left ventricular dysfunction; levosimendan