LEVOSIMENDAN FOR INTENSIVE THERAPY OF HEART FAILURE IN HEART VALVE PROSTHETICS

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Abstract

The article describes perioperative periods of two patients who underwent surgical repair of acquired heart valve disease with artificial circulatory support. In both cases, there was decompensation of chronic heart failure, with levosimendan (Symdax, Orion Pharma, Finland) being used for its treatment. In the first case the drug was infused in the early postoperative period, without a loading dose, at a rate of 0.05–0.1 mcg/kg/min for 26 hours. After 3 hours, an improvement was observed and after 36 hours classic inotropes were stopped. After further 36 hours (day 3) the patient was moved to a surgical department ward. In the second case, due to an extremely low cardiac index, levosimendan was administered proactively starting one day before surgery. However, a long period of artificial circulation, perfusion problems due to thrombosis during artificial circulatory support led to deterioration of chronic renal failure, chronic heart failure and to death within the first 10 hours after surgery. Conclusion: Levosimendan is an effective drug for treatment of heart failure in cardiac surgery patients. However, it is unlikely to solve all problems of early postoperative period in patients with multiple organ failure.

About the authors

O. N. Ulitkina

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: ulitkinaON@gmail.com

Anesthesiologist, Department of Cardiac Intensive Care

Russian Federation

Zh. S. Filippovskaya

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Head of Department of Cardiac Intensive Care

Russian Federation

A. A. Tereshina

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Anesthesiologist, Department of Anesthesiology

Russian Federation

O. A. Grebenchikov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

PhD, Senior Research Fellow, Department of Intensive Care

Russian Federation

R. A. Cherpakov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Anesthesiologist, Department of Cardiac Intensive Care

Russian Federation

V. E. Babokin

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

PhD, Head of Department of Cardiac Surgery

Russian Federation

A. M. Ovezov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Head of Department of Anesthesiology, Head of Chair of Anesthesiology and Reanimatology, Postgraduate Training Faculty

Russian Federation

V. V. Likhvantsev

Moscow Regional Research and Clinical Institute (MONIKI)

Email: lik0704@gmail.com

MD, PhD, Professor, Head of Department of Intensive Care

Russian Federation

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Copyright (c) 2015 Ulitkina O.N., Filippovskaya Z.S., Tereshina A.A., Grebenchikov O.A., Cherpakov R.A., Babokin V.E., Ovezov A.M., Likhvantsev V.V.

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