Levosimendan for Hemodynamic Support after Cardiac Surgery

In a randomized trial, 506 patients requiring perioperative hemodynamic support after cardiac surgery were assigned to receive levosimendan or placebo in addition to standard care. There was no significant between-group difference in 30-day mortality. Every year, more than 1 million patients undergo cardiac surgery in the United States and Europe. 1 Acute perioperative left ventricular dysfunction is a major complication affecting up to 20% of such patients 2 , 3 and is associated with increased mortality. 4 Inotropic drugs (catecholamines and phosphodiesterase type 3 [PDE-3] inhibitors) are the cornerstone of postoperative hemodynamic support. 3 , 5 However, no randomized, controlled trials have shown the superiority of any inotropic agent in terms of major clinical outcomes. Furthermore, meta-analyses and observational studies suggest that catecholamines and PDE-3 inhibitors may increase mortality. 6 , 7 Levosimendan (Simdax, Orion) is an inotropic agent that has been . . .