3 years ago

Cardiovascular highlights from non-cardiology journals

Levosimendan for hemodynamic support after cardiac surgery

Left ventricular dysfunction following cardiac surgery remains a significant perioperative challenge, one often treated with inotropic support, however practice patterns vary widely and there are few outcome data to support a standardised practice. Levosimendan represents a newer class of ‘inodilators’, calcium sensitizers, thought to improve cardiac output without increasing myocardial oxygen consumption. In the Levosimendan to Reduce Mortality in High Risk Cardiac Surgery Patients (CHEETAH) randomised trial, 506 patients with a preoperative ejection fraction <25%, a preoperative need for intraaortic balloon pump (IABP) support, or post-operative need for support with IABP or high-dose inotropes within 24 hours of cardiopulmonary bypass were randomised 1:1 to receive either levosimendan infusion or placebo plus standard medical therapy in a double-blinded fashion. The primary outcome of the study was 30 day mortality. No difference in the primary outcome was found between the levosimendan group (12.9% mortality) and the...

Publisher URL: http://heart.bmj.com/cgi/content/short/103/19/1553

DOI: 10.1136/heartjnl-2017-312223

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