An Evaluation on the Effect of Preoperative Levosimendan Administration as an Inotropic Agent in Patients Undergoing Open Heart Surgery with Poor Ventricular Function

Aim: Nowadays, we frequently encounter with articles related with preoperative use of Levosimendan in literature. Aim of this paper was to present our clinical experience which was in accordance with the literature rather than comparing or suggesting new clinical data. Background and Objectives: Most important preoperative risk factor in cardiac surgery is poor ventricular function which directly affects morbidity and mortality. An effective agent named Levosimendan has inotropic and myocardial anti-ischemic effects without increasing myocardial oxygen demand. In this paper, we aimed to present our experience with levosimendan infusion started at 24 hours before operation in patients undergoing open heart surgery with poor ventricular function. Subjects and Methods: Patients underwent cardiac surgery in our clinic between August 2009-August 2015 were retrospectively evaluated. Among them, 26 patients whose preoperative left ventricular ejection fraction (LVEF) value below 30% were enrolled. These patients had been receiving Levosimendan after admitted to intensive care unit at 24 hours before operation according to our clinical protocol. Pre-operative and post-operative characteristics of patients were collected. Results: All patients weaned from cardiopulmonary bypass (CPB) without complications. There was no intraoperative or early postoperative mortality. Post-operative EF values were 32% and 37% at first postoperative week and first postoperative month; respectively. Conclusion: Both of our results and our clinical experience suggested that Levosimendan use during early preoperative period in these patients with high risk is more advantageous than administration during other periods.