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 valve replacement. Methods Patients undergoing open heart aortic and/or mitral valve replacement in our hospital from January 2018 to December 2019 were enrolled. 45 patients in the control group received routine perioperative treatment based on dopamine, while 45 patients in the research group received continuous perioperative administration of levosimendan injection for 24h on the basis of routine treatment. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDd) and left ventricular end-systolic diameter (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 and withdrawal 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 The improvement of LVDs and LVEF in the study group using levosimendan one week after the operation was significantly better than that in the control group (P value was 0.013 and 0.001, respectively), and fewer kinds of vasoactive drugs were needed (P<0.001), and the risk of postoperative AKI in the study group was significantly lower than that in the control group ( P=0.047 ). Conclusion The perioperative use of levosimendan can effectively promote the recovery of cardiac systolic function and reduce the risk of postoperative AKI.