title: Preoperative levosimendan in ischemic mitral valve repair.
abstract: BACKGROUND
  Levosimendan is a new calcium sensitizing drug with vasodilatory and inotropic properties, which is used for the treatment of postoperative low cardiac output syndrome and difficult weaning from cardiopulmonary bypass.
  
  
  OBJECTIVE
  To evaluate the hemodynamic effects of levosimendan during and after coronary artery bypass grafting on cardiopulmonary bypass and mitral valve repair in patients with low left ventricular ejection fractions (<30%).
  
  
  METHODS
  40 patients were enrolled in this double-blind prospective randomized controlled trial. They received either levosimendan or a placebo preoperatively (n = 20) for 24 h. Clinical parameters were measured before and after administration. Any adverse events during and after drug administration and postoperative complications were evaluated.
  
  
  RESULTS
  Patients treated with levosimendan exhibited a higher cardiac index and mean arterial pressure intraoperative and in the early postoperative period, compared to the control group. Patients treated with levosimendan required less ventilatory support (p < 0.0001) and had shorter intensive care unit (p < 0.0001) and hospital stay (p < 0.0001).
  
  
  CONCLUSIONS
  Preoperative treatment with levosimendan in patients undergoing coronary artery bypass grafting and mitral valve repair resulted in improved hemodynamics and a stable postoperative course.
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India realpranav@yahoo.com.
authors.forename: Pranav
authors.initials: P
authors.lastname: Sharma
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
authors.forename: Amber
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gandhi
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Bishnoi
authors.affiliation: UN Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
authors.forename: Hemang
authors.initials: H
authors.lastname: Gandhi
mesh_terms: D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage* / Q000009:adverse effects; D007194:India; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011300:Preoperative Care; D011446:Prospective Studies; D011724:Pyridazines / Q000008:administration & dosage* / Q000009:adverse effects; D012121:Respiration, Artificial; D000077464:Simendan; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan
keywords: Cardiac valve annuloplasty; Cardiopulmonary bypass; Cardiotonic agents; Coronary artery bypass; Levosimendan; Ventricular function