title: Preoperative optimization with levosimendan in heart failure patient undergoing thoracic surgery.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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. The patient was under continuous hemodynamic monitoring prior, during and after levosimendan administration. The surgery for pleural biopsy was performed with uniportal Video Assisted Thoracoscopic approach (VATS).
  
  
  CONCLUSIONS
  A significant increase of Cardiac Index (CI) and Stroke Volume Index (SVI) were observed at 4h after infusion initiation and was sustained during the next 24h after the end of infusion. Levosimendan administration was safe.
  
  
  CONCLUSIONS
  In this case the prophylactic preoperative levosimendan administration is safe and effective in cardiac failure patient undergoing thoracic surgery, but prophylactic preoperative levosimendan treatment in these patients merits further study.
authors: Anesthesia and Intensive Care, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy.
authors: Moana Rossella
authors: MR
authors: Nespoli
authors: Anesthesia and Intensive Care, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy. Electronic address: marco-rispoli@hotmail.it.
authors: Marco
authors: M
authors: Rispoli
authors: Anesthesia and Intensive Care, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy. Electronic address: dario.mattiacci@libero.it.
authors: Dario Maria
authors: DM
authors: Mattiacci
authors: Anesthesia and Intensive Care, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy.
authors: Marianna
authors: M
authors: Esposito
authors: Thoracic Surgery, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy.
authors: Antonio
authors: A
authors: Corcione
authors: Thoracic Surgery, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy.
authors: Carlo
authors: C
authors: Curcio
authors: Thoracic Surgery, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy. Electronic address: mauro97@libero.it.
authors: Salvatore
authors: S
authors: Buono
keywords: Heart failure patient; Levosimendan; Preoperative optimization; Thoracic surgery