Clinical study of Perioperative Use of Levosimendan in Patients Undergoing Heart Valve Replacement

ABSTRACT

Objective To investigate the clinical effect of levosimendan in perioperative aortic and/or mitral valvereplacement. Methods Patients undergoing open heart aortic and/or mitral valve replacement in our hospitalfrom January 2018 to December 2019 were enrolled. 45 patients in the control group received routineperioperative treatment based on dopamine, while 45 patients in the research group received continuousperioperative administration of levosimendan injection for 24h on the basis of routine treatment. The leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDd) and left ventricular end-systolicdiameter (LVDs) were evaluated by color doppler echocardiography before and one week after surgery.Postoperative mechanical ventilation weaning time, length of ICU stays, number of vasoactive drugs used andwithdrawal time; indexes of liver and kidney function before and on the day after surgery to 10 days after surgery;use of in vitro support techniques such as aortic balloon pulsation (IABP), continuous renal replacement therapy(CRRT) and extracorporeal membrane oxygenation (ECMO) within 5 days of perioperative period. Results Theimprovement of LVDs and LVEF in the study group using levosimendan one week after the operation wassignificantly better than that in the control group (P value was 0.013 and 0.001, respectively), and fewer kinds ofvasoactive drugs were needed (P<0.001), and the risk of postoperative AKI in the study group was significantlylower than that in the control group (P=0.047). Conclusion The perioperative use of levosimendan can effectivelypromote the recovery of cardiac systolic function and reduce the risk of postoperative AKI.