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Exploring the role of prophylactic levosimendan in coronary surgery

中华胸部外科电子杂志 2022年第1期9卷 1-11,I0001-I0003页

作者： Giuseppe Gatti Marina Bollini Aldostefano Porcari Federico Biondi Alessandro Ceschia Davide Stolfo Francesco Bianco lorella dreas Cardio-Thoracic and Vascular Department Trieste University HospitalTriesteItaly Department of Nephrology Trieste University HospitalTriesteItaly

Background:The role of prophylactic levosimendan in coronary surgery has not been established ***:Postoperative outcomes of 139 patients(mean age,68.2±9.6 years)having preoperative left ventricular ejection fraction(LVEF)≤40%and undergoing isolated coronary surgery(2013-2017)were reviewed *** 42(30.2%)patients(L-group),an intravenous infusion of levosimendan was started 24 hours before *** remaining 97(69.8%)patients were the control group(C-group).A comparison between the two groups regarding outcome of surgery was performed also after propensity ***:Although the risk profile in L-patients was higher than in C-patients(median European System for Cardiac Operative Risk Evaluation II,10.5%vs.6.5%,P=0.013)due to higher prevalence of New York Heart Association class III-IV,LVEF≤30%,and preoperative intra-aortic balloon pump,in-hospital mortality was equivalent(4.8%vs.3.1%,P=0.48).However,low cardiac output,multiple blood transfusion,and any major complication early after surgery were more frequent in *** one-to-one propensity matching,which resulted in 15 pairs with similar baseline characteristics the use of levosimendan was associated with a trend towards an increased blood use(P=0.077),a higher frequency of any major complication(P=0.053),and lower peak serum levels of cardiac troponin I(P=0.088).No intergroup differences concerning mid-term survival or outcomes were found even for matched ***:When compared with traditional inotropes alone,prophylactic use of levosimendan showed clear benefits/drawbacks neither concerning immediate nor mid-term outcomes after coronary *** could be any advantage in terms of myocardial preservation.

关键词： Coronary artery bypass grafting(CABG) left ventricular dysfunction levosimendan morbidity/mortality prophylaxis

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