Preoperative levosimendan infusion in combined aortic valve and coronary bypass surgery

Leppikangas, Heli; Järvelä, Kati; Sisto, Tero; Maaranen, Pasi; Virtanen, Marko; Lehto, Pasi; Karlsson, Sari; Kööbi, Tiit; Lindgren, L.

doi:10.1093/bja/aeq402

Cited by 61 publications

(30 citation statements)

References 27 publications

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“…Further filtering led to 60 articles scanned during the abstract review. From the 27 full‐text articles reviewed, 14 studies were finally included for systematic review and meta‐analysis . Figure depicts the flow diagram for the search process.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Levosimendan Reduces Mortality in Adults with Left Ventricular Dysfunction Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

et al. 2015

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Section: Resultsmentioning

confidence: 99%

“…From the 27 full-text articles reviewed, 14 studies were finally included for systematic review and meta-analysis. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] Figure 1 depicts the flow diagram for the search process. Tables 1 and 2 present an overview and quality review of the included studies.…”

Section: Resultsmentioning

confidence: 99%

Levosimendan Reduces Mortality in Adults with Left Ventricular Dysfunction Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

et al. 2015

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“…Optimizing cardiac function could be a good strategy to minimize the risk of postoperative AKI, according to Leppikangas et al [27] . They reported that the use of preoperative calcium sensitizer infusion could be a good strategy to improve left ventricular EF in patients with high-risk cardiac surgery [27] .…”

Section: Discussionmentioning

confidence: 99%

“…They reported that the use of preoperative calcium sensitizer infusion could be a good strategy to improve left ventricular EF in patients with high-risk cardiac surgery [27] .…”

Section: Discussionmentioning

confidence: 99%

Predictors of Postoperative Acute Kidney Injury after Coronary Artery Bypass Graft Surgery

Ortega-Loubón¹,

Fernández-Molina²,

Pañeda-Delgado³

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveThe aims of this study were to identify the risk factors associated with acute kidney injury (AKI) after isolated surgical revascularization with cardiopulmonary bypass and to develop a model to predict the appearance of postoperative AKI.MethodsA total of 435 adult patients who underwent primary isolated coronary artery bypass graft (CABG) surgery, from 2012 to 2016, in the Clinic University Hospital of Valladolid (Spain) were enrolled. AKI was defined according to the risk, injury, failure, loss, and end-stage (RIFLE) criteria. Data were collected from hospital electronic medical records. Multiple logistic regression analysis was used to identify risk factors.ResultsThe prevalence of AKI was 12.4%. Multivariate analysis identified age (odds ratio [OR], 1.056; 95% confidence interval [CI], 1.016-1.098; P=0.005), hypertension (OR, 3.078; 95% CI, 1.151-8.230; P=0.018), low ejection fraction (EF) (OR, 6.785; 95% CI, 2.080-22.135; P=0.001), estimated glomerular filtration rate (eGFR) (OR, 1.017; 95% CI, 1.005-1.028; P=0.014), EuroSCORE II (OR, 1.049; 95% CI, 1.004-1.096; P=0.033), and no intake of calcium-channel blockers (CCB) (OR, 4.892; 95% CI, 1.496-16.025; P=0.022) as risk factors for AKI. These risk factors were included in a model to predict postoperative AKI with an area under a receiver operating characteristic curve of 0.783±0.036 (95% CI, 0.713-0.854; P<0.0001).ConclusionAge, hypertension, low EF, eGFR, EuroSCORE II, and no intake of CCB were independent risk factors for postoperative AKI. These factors provide an easy and accurate model to predict postoperative AKI in patients undergoing cardiac surgery.

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“…Myocardial dysfunction may reduce exercise tolerance and limit early postoperative physical activity. Whereas postoperative myocardial function at rest has been extensively investigated (Ng et al, 2005;Apostolakis et al, 2009;Leppikangas et al, 2011;Juhl-Olsen et al, 2012;Hashemi et al, 2013), less is known about myocardial function during physical activity in the early postoperative phase.…”

Section: Introductionmentioning

confidence: 99%

Cardiac function assessed by exercise echocardiography on the first morning after coronary artery bypass grafting

Dedichen

Kirkeby‐Garstad

Aadahl

et al. 2014

Clin Physio Funct Imaging

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Cardiac surgery patients are urged to resume light physical activity on the first postoperative day, even if cardiac function may not have recovered fully after the operation. To elucidate the postoperative recovery process, we examined cardiac surgery patients with exercise echocardiography before and on the first day after the operation. Patients undergoing on-pump coronary artery bypass grafting were examined with echocardiography during semirecumbent cycle exercise. Patients exercised for five minutes at 10 W intensity and five minutes at 30 W intensity in bed with the upper body supported to approximately 30°. Fourteen patients were studied. Mitral annulus excursion and pulsed wave Doppler from the left ventricular outflow tract indicated postoperatively reduced cardiac stroke volume. Early diastolic tissue velocities of the mitral annulus were reduced, and early trans-mitral flow velocity was increased. The ratio between early mitral flow velocity and early diastolic mitral tissue velocity was increased postoperatively, indicating impaired left ventricular relaxation and increased left atrial pressure. Postoperative systolic mitral annulus tissue velocities were similar to preoperative velocities, indicating maintained systolic function. Postoperative exercise was associated with improvements in myocardial function indices and cardiac stroke volume similar to preoperative improvements. There were no signs of further deterioration in myocardial function during 30 W exercise. In summary, reduced left ventricular diastolic function after surgery resulted in reduced cardiac stroke volume, increased left atrial pressure and a higher rate of perceived exertion on the first postoperative day.

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Preoperative levosimendan infusion in combined aortic valve and coronary bypass surgery

Abstract: Levosimendan improved haemodynamics compared with a placebo in patients undergoing high-risk cardiac surgery. The concentrations of levosimendan's metabolites were higher compared with earlier studies using perioperative dosing.

Cited by 61 publications

References 27 publications

Levosimendan Reduces Mortality in Adults with Left Ventricular Dysfunction Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

Levosimendan Reduces Mortality in Adults with Left Ventricular Dysfunction Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

Predictors of Postoperative Acute Kidney Injury after Coronary Artery Bypass Graft Surgery

Cardiac function assessed by exercise echocardiography on the first morning after coronary artery bypass grafting

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