Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation.
Authors
Abdelshafy, MahmoudElsherbini, Hagar
Elkoumy, Ahmed
Simpkin, Andrew J
Elzomor, Hesham
Caliskan, Kadir
Soliman, Osama
Issue Date
2022-04-28Keywords
LVADHEART FAILURE
inotropes
levosimendan
mechanical circularity support
right-sided heart failure
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Show full item recordJournal
Frontiers in cardiovascular medicineDOI
10.3389/fcvm.2022.888136PubMed ID
35571194Abstract
Left ventricular assist device (LVAD) therapy has been instrumental in saving lives of patients with end-stage heart failure (HF). Recent generation devices have short-to-mid-term survival rates close to heart transplantation. Unfortunately, up to 1 in 4 patients develop a life-threatening right-sided HF (RHF) early post LVAD implantation, with high morbidity and mortality rate, necessitating prolonged ICU stay, prolonged inotropic support, and implantation of a right-ventricular assist device. Pre-operative optimization of HF therapy could help in prevention, and/or mitigation of RHF. Levosimendan (LEVO) is a non-conventional inotropic agent that works by amplifying calcium sensitivity of troponin C in cardiac myocytes, without increasing the intra-cellular calcium or exacerbating ischemia. LEVO acts as an inodilator, which reduces the cardiac pre-, and after-load. LEVO administration is associated with hemodynamic improvements. Despite decades long of the use of LVAD and more than two decades of the use of LEVO for HF, the literature on LEVO use in LVAD is very limited. In this paper, we sought to conduct a systematic review to synthesize evidence related to the use of LEVO for the mitigation and/or prevention of RHF in patients undergoing LVAD implantation.Item Type
ArticleLanguage
enISSN
2297-055Xae974a485f413a2113503eed53cd6c53
10.3389/fcvm.2022.888136
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