Usage and Results of Levosimendan in Ischemic Mitral Valve Surgery

Abstract

Objective: Large number of comprehensive studies has been carried out on levosimendan. There are many studies on its use, especially in cardiac dysfunction, ischemic cardiac surgery, and heart transplantation surgery. But, there are limited number of studies regarding its use in mitral valve interventions and ischemic mitral dysfunction combined with coronary artery by-pass surgery (CABG). We aimed to investigate the efficacy of levosimendan usage on patients undergone combined coronary artery by-pass grafting and mitral valve surgery because of ischemic mitral dysfunction. Methods: Subsequent patients, who have undergone concurrent CABG and mitral valve repair surgery by a single surgery team, were retrospectively examined. 36 patients were divided into 2 groups; Group 1 (levosimendan therapy group, n=15) and Group 2 (n=21). Results: There was no statistically significant difference between the groups in terms of preoperative characteristics, echocardiographic data of the patients and preoperative medication. Inotrope therapy was required for 12 patients in Group 1, which was statistically higher than Group 2 (n=5, p=0.001). Moreover, IABP following LCOS utilized six and two patients in group 1 and 2 with a statistically significant difference (p=0.03), respectively. Conclusion: We recommend using levosimendan on selected patients for its several beneficial effects. However, we do not satisfied with the treatment because the pathology of all patients was not related to ischemia, more to the alteration of ventricle anatomy with deterioration of diameters.