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Ann Thorac Surg 2006;81:1536-1546
© 2006 The Society of Thoracic Surgeons

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Review

Levosimendan in Cardiac Surgery: Current Best Available Evidence

^a Department of Cardiac Surgery, Royal Hospital for Sick Children, Glasgow, United Kingdom
^b Department of Cardiology, Royal Hospital for Sick Children, Glasgow, United Kingdom

Accepted for publication August 25, 2005.

^_* Address correspondence to Dr Raja, Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill NHS Trust, Dalnair Street, Glasgow G3 8SJ, United Kingdom (Email: drrajashahzad{at}hotmail.com).

Recent upsurge in referral of patients with high perioperative risk or compromised left ventricular function for cardiac surgery has lead to an increasing use of pharmacologic support in the form of vasodilator and inotropic therapy to achieve improvement of tissue perfusion in the perioperative period or to support weaning from cardiopulmonary bypass. Traditionally, perioperatively used inotropic agents, epinephrine, dobutamine, and milrinone, are limited by significant increases in myocardial oxygen consumption, proarrhythmia, or neurohormonal activation. Levosimendan, a new inodilator for the treatment of decompensated heart failure, has also shown promise in elective therapy of cardiac surgical patients with high perioperative risk or compromised left ventricular function, as well as in rescue therapy of patients with difficult weaning from cardiopulmonary bypass. This review article briefly discusses the pharmacology of levosimendan and evaluates current best available evidence to assess the safety and efficacy of levosimendan usage in cardiac surgery.

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