Levosimendan as a New Strategy During Off-pump Coronary Artery Bypass Grafting: Double-blind Randomized Placebo-controlled Trial

Husedžinović, Ino; Barišin, Stjepan; Bradić, Nikola; Barišin, Ana; Sonicki, Zdenko; Milanović, Rudolf
December 2005
Croatian Medical Journal;2005, Vol. 46 Issue 6, p950
Academic Journal
Aim To determine if levosimendan could improve cardiac performance during off-pump coronary artery bypass grafting in patients with normal preoperative left ventricular function. Methods Twenty-four patients included in this double-blind randomized controlled trial received either placebo (n=12) or 12 µg/kg loading dose of levosimendan (n=12) during a period of 15 minutes before the surgery. The heart rate, cardiac index, stroke volume index, and left ventricular ejection fraction were measured before and 10 and 60 minutes after the drug administration. Results The baseline measurements of hemodynamic parameters did not differ between the groups. Heart rate was not significantly different between the placebo and levosimendan group. Compared with placebo group, cardiac index and left ventricular ejection fraction were significantly higher 10 and 60 minutes (p=0.018 for all) after administration of levosimendan. After 60 minutes, the cardiac index increased from the baseline value of 2.18 to 2.84 L/min/m2. Left ventricular ejection fraction increased by14% after 10 minutes, and by 10% after 60 minutes. Stroke volume index was significantly higher at 10 minutes (p=0.018), but not at 60 minutes (p=0.063) after the administration of levosimendan. Conclusion Administration of 12 µg/kg of levosimendan enhances the left ventricular performance and offers a promising therapeutic option during off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function.


Related Articles

  • Trans-esophageal echocardiography in off-pump coronary artery bypass grafting. Kapoor, Poonam Malhotra; Chowdhury, Ujjwal; Mandal, Banashree; Kiran, Usha; Karnatak, Rajendra // Annals of Cardiac Anaesthesia;Jul2009, Vol. 12 Issue 2, following p176 

    Two features of off-pump coronary artery bypass (OPCAB) can lead to hemodynamic instability: transient occlusion of coronary arteries during distal anastomosis construction and displacement of the heart to provide access to distal coronary arteries. The position of the heart during OPCAB...

  • Performance of three preoperative risk indices; CABDEAL, EuroSCORE and Cleveland models in a prospective coronary bypass database. Kurki, Tuula S.; Järvinen, Otso; Kataja, Matti J.; Laurikka, Jari; Tarkka, Matti // European Journal of Cardio-Thoracic Surgery;Mar2002, Vol. 21 Issue 3, p406 

    Objectives: The aim of the present study was to evaluate the performance of three different preoperative risk models in the prediction of postoperative morbidity and mortality in coronary artery bypass (CAB) surgery. Methods: Data on 1132 consecutive CAB patients were prospectively collected,...

  • Benefits of a Supervised Exercise Program After Lower Limb Bypass Surgery. Badger, Stephen A.; Soong, Chee V.; O'Donnell, Mark E.; Boreham, Colm A. G.; McGuigan, Kathy E. // Vascular & Endovascular Surgery;Feb/Mar2007, Vol. 41 Issue 1, p27 

    This study evaluated the efficacy of an exercise program after arterial bypass surgery. Patients undergoing bypass surgery were randomized to a control group (group I), with standard preoperative and postoperative care, or the intervention group (group II) with a supervised exercise program of...

  • Hemocompatibility of a coaxial pump catheter for less invasive heart surgery. Mueller, Xavier M; Augstburger, Monique; Boone, Yves; von Segesser, Ludwig K // Perfusion;Jan2002, Vol. 17 Issue 1, p3 

    Off-pump coronary artery bypass (OPCAB) requires heart manipulation during exposure of the lateral and posterior walls of the heart, which may cause hemodynamic instability, mainly through right ventricular dysfunction. A coaxial atrial cannula connected to a minicentrifugal pump was developed...

  • PREOPERATIF ACE INHIBIT�R� KULLANIMININ KARDIYOPULMONER BYPASS ILE KORONER ARTER BYPASS SONRASI HEMODINAMI �ZERINE ETKISI. G�lmen, Senol; Tuncer Peker, T�lay; Kiris, Ilker; Dogan, Emre; Yavuz, Turhan; Okutan, H�seyin // Anatolian Journal of Clinical Investigation;2011, Vol. 5 Issue 1, p42 

    The aim of the present study was to investigate the hemodynamic effects of preoperatively used angiotensinconverting enzyme inhibitors in intraoperative and early postoperative period in patients undergoing coronary artery bypass surgery with cardiopulmonary bypass. Forty patients (33 male, mean...

  • Role of IABP in OPCAB - a vettath's modification. Vettath, M.; Tazhakuni, E. I.; Veluchamy, A. K. // Journal of Cardiothoracic Surgery;2013, Vol. 8 Issue Suppl 1, p1 

    An abstract of the article "Role of IABP in OPCAB - a vettath's" by M. Vettath and colleagues is presented.

  • Hemodynamic changes during off-pump CABG surgery. Do, Quoc-Bao; Goyer, Caroline; Chavanon, Olivier; Couture, Pierre; Denault, André; Cartier, Raymond // European Journal of Cardio-Thoracic Surgery;Mar2002, Vol. 21 Issue 3, p385 

    Objectives: The purpose of this study was to assess the patients'' hemodynamics during off-pump coronary artery bypass graft (OPCABG) surgery. Methods: Continuous monitoring of the mean systemic arterial pressure (SAP), mean pulmonary arterial pressure (PAP), mixed venous oxygen saturation...

  • Father fights back over school age admission policy. Morton, Katy // Nursery World (Haymarket Business Publications Ltd);6/11/2012, Vol. 112 Issue 4295, p4 

    The article reports that Stefan Richter, a father of three children, is calling for flexibility in the schools admission system in Great Britain. He wants to defer the school entry of his two-year-old daughter to enable her to start reception after her fifth birthday at the end of August 2012....

  • A study of the physiological consequences of sympathetic denervation of the heart caused by the arterial switch procedure. Falkenberg, Cecilia; Hallhagen, Stefan; Nilsson, Krister; Nilsson, Boris; Östman-Smith, Ingegerd // Cardiology in the Young;Apr2010, Vol. 20 Issue 2, p150 

    Background: The arterial switch operation is the corrective operation for transposition of the great arteries, defined as the combination of concordant atrioventricular and discordant ventriculo-arterial connections, but there have been concerns about silent subendocardial ischaemia on exercise...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics