Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP

Sherif Nasr; Hesham Alkady; Ahmed Saber; Ahmed Elsharkawy; Eman Mahmoud

doi:doi:10.11648/j.ijcts.20190502.15

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Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP

Sherif Nasr, Hesham Alkady, Ahmed Saber, Ahmed Elsharkawy, Eman Mahmoud

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 2)

Received: 4 May 2019 Accepted: 2 June 2019 Published: 12 June 2019

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Abstract

Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 2)
DOI	10.11648/j.ijcts.20190502.15
Page(s)	51-55
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

CABG Surgery, Levosimendan Infusion, Intra-aortic Balloon Counter-pulsation Pump

References

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[2]	Harrison RW, Hasselblad V, Mehta RH, Levin R, Harrington RA, Alexander JH. Effect of levosimendan on survival and adverse events after cardiac surgery: a meta-analysis. J Cardiothorac Vasc Anesth 2013; 27: 1224–32.
[3]	Kolseth SM, Nordhaug DO, Stenseth R, Sellevold O, Kirkeby-Garstad I, Wahba A. Prophylactic treatment with levosimendan: a retrospective matched-control study of patients with reduced left ventricular function. Eur J Cardiothorac Surg. 2009 Dec; 36: 1024-30.
[4]	Leppikangas H, Järvelä K, Sisto T, Maaranen P, Virtanen M, Lehto P, Karlsson S, Kööbi T, Lindgren L. Preoperative levosimendan infusion in combined aortic valve and coronary bypass surgery. Br J Anaesth. 2011 Mar; 106: 298-304.
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[7]	Lim JY, Deo SV, Rababa'h A, Altarabsheh SE, Cho YH, Hang D, McGraw M, Avery EG, Markowitz AH, Park SJ. Levosimendan reduces mortality in adults with left ventricular dysfunction undergoing cardiac surgery: a systematic review and metaanalysis. J Card Surg 2015; 30: 547–54.
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APA Style

Sherif Nasr, Hesham Alkady, Ahmed Saber, Ahmed Elsharkawy, Eman Mahmoud. (2019). Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. International Journal of Cardiovascular and Thoracic Surgery, 5(2), 51-55. https://doi.org/10.11648/j.ijcts.20190502.15

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ACS Style

Sherif Nasr; Hesham Alkady; Ahmed Saber; Ahmed Elsharkawy; Eman Mahmoud. Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(2), 51-55. doi: 10.11648/j.ijcts.20190502.15

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AMA Style

Sherif Nasr, Hesham Alkady, Ahmed Saber, Ahmed Elsharkawy, Eman Mahmoud. Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. Int J Cardiovasc Thorac Surg. 2019;5(2):51-55. doi: 10.11648/j.ijcts.20190502.15

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@article{10.11648/j.ijcts.20190502.15,
  author = {Sherif Nasr and Hesham Alkady and Ahmed Saber and Ahmed Elsharkawy and Eman Mahmoud},
  title = {Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {5},
  number = {2},
  pages = {51-55},
  doi = {10.11648/j.ijcts.20190502.15},
  url = {https://doi.org/10.11648/j.ijcts.20190502.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190502.15},
  abstract = {Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.},
 year = {2019}
}

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TY  - JOUR
T1  - Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP
AU  - Sherif Nasr
AU  - Hesham Alkady
AU  - Ahmed Saber
AU  - Ahmed Elsharkawy
AU  - Eman Mahmoud
Y1  - 2019/06/12
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcts.20190502.15
DO  - 10.11648/j.ijcts.20190502.15
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 51
EP  - 55
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20190502.15
AB  - Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.
VL  - 5
IS  - 2
ER  -

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Author Information

Sherif Nasr

Department of Cardiothoracic Surgery, Fayoum University, Fayoum, Egypt
Hesham Alkady

Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt
Ahmed Saber

Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt
Ahmed Elsharkawy

Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt
Eman Mahmoud

Department of Cardiology, Fayoum University, Fayoum, Egypt

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Plain Text BibTeX RIS

APA Style

Sherif Nasr, Hesham Alkady, Ahmed Saber, Ahmed Elsharkawy, Eman Mahmoud. (2019). Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. International Journal of Cardiovascular and Thoracic Surgery, 5(2), 51-55. https://doi.org/10.11648/j.ijcts.20190502.15

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ACS Style

Sherif Nasr; Hesham Alkady; Ahmed Saber; Ahmed Elsharkawy; Eman Mahmoud. Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(2), 51-55. doi: 10.11648/j.ijcts.20190502.15

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AMA Style

Sherif Nasr, Hesham Alkady, Ahmed Saber, Ahmed Elsharkawy, Eman Mahmoud. Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP. Int J Cardiovasc Thorac Surg. 2019;5(2):51-55. doi: 10.11648/j.ijcts.20190502.15

Copy | Download

@article{10.11648/j.ijcts.20190502.15,
  author = {Sherif Nasr and Hesham Alkady and Ahmed Saber and Ahmed Elsharkawy and Eman Mahmoud},
  title = {Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {5},
  number = {2},
  pages = {51-55},
  doi = {10.11648/j.ijcts.20190502.15},
  url = {https://doi.org/10.11648/j.ijcts.20190502.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190502.15},
  abstract = {Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP
AU  - Sherif Nasr
AU  - Hesham Alkady
AU  - Ahmed Saber
AU  - Ahmed Elsharkawy
AU  - Eman Mahmoud
Y1  - 2019/06/12
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcts.20190502.15
DO  - 10.11648/j.ijcts.20190502.15
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 51
EP  - 55
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20190502.15
AB  - Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.
VL  - 5
IS  - 2
ER  -

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