Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation

Frontiers in Cardiovascular Medicine

article

Mahmoud Abdelshafy¹  Hagar Elsherbini⁴  Ahmed Elkoumy¹  Andrew J. Simpkin⁶  Hesham Elzomor¹  Kadir Caliskan³  Osama Soliman¹ 

[1] Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital;CORRIB Core Lab, National University of Ireland Galway;Department of Cardiology, Al-Azhar University;Department of Cardiology, Erasmus MC University Medical Center;Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University;School of Mathematical and Statistical Sciences, National University of Ireland Galway;Insight Centre for Data Analytics, National University of Ireland Galway;CÚRAM Centre for Medical Devices

关键词: levosimendan;    LVAD;    right-sided heart failure;    inotropes;    mechanical circularity support;    heart failure;   

DOI  :  10.3389/fcvm.2022.888136

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY