ArticleJournal of cardiothoracic surgery2020
Preconditioning with levosimendan reduces postoperative low cardiac output in moderate-severe systolic dysfunction patients who will undergo elective coronary artery bypass graft surgery: a cost-effective strategy.
Article in Journal of cardiothoracic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Preoperative Administration of Levosimendan to Prevent Low Cardiac Output Syndrome Following Pediatric Cardiac Surgery: A Retrospective Study.Clinics and practice · 2026Article
- Intravenous Levosimendan versus Inhalational Milrinone in the Management of Pulmonary Hypertension during Adult Cardiac Surgery: A Randomized Clinical Trial.Life (Basel, Switzerland) · 2024Article
- Monitoring of Levosimendan Administration in Patients with Pulmonary Hypertension Undergoing Cardiac Surgery and Effect of Two Different Dosing Schemes on Hemodynamic and Echocardiographic Parameters.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Influence of timing of Levosimendan administration on outcomes in cardiac surgery.Frontiers in cardiovascular medicine · 2023Article
- The evaluation of levosimendan in patients with acute myocardial infarction related ventricular septal rupture undergoing cardiac surgery: a prospective observational cohort study with propensity score analysis.BMC anesthesiology · 2022Observational
- Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety.Journal of anesthesia, analgesia and critical care · 2022Review
- The effects of levosimendan in patients undergoing transcatheter aortic valve replacement- a retrospective analysis.Frontiers in pharmacology · 2022Article
- Levosimendan improves postoperative heart function recovery and prognosis in patients with heart disease.American journal of translational research · 2022Article
- Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- [Levosimendan and postcardiotomy low cardiac output syndrome: indisputable evidence or mere statistical coincidence?]Archivos peruanos de cardiologia y cirugia cardiovascularArticle
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with moderate-severe systolic dysfunction undergoing coronary artery bypass graft have a higher incidence of postoperative low cardiac output. Preconditioning with levosimendan may be a useful strategy to prevent this complication. In this context, design cost-effective strategies like preconditioning with levosimendan may become necessary.
methodsIn a sequential assignment of patients with Left Ventricle Ejection Fraction less than 40%, two strategies were compared in terms of cost-effectiveness: standard care (n = 41) versus preconditioning with Levosimendan (n = 13). The adverse effects studied included: postoperative new-onset atrial fibrillation, low cardiac output, renal failure and prolonged mechanical ventilation. The costs were evaluated using deterministic and probabilistic sensitivity analysis, and Monte Carlo simulations were performed.
resultsPreconditioning with levosimendan in moderate to severe systolic dysfunction (Left Ventricle Ejection Fraction < 40%), was associated with a lower incidence of postoperative low cardiac output in elective coronary artery bypass graft surgery 2(15.4%) vs 25(61%) (P < 0.01) and lesser intensive care unit length of stay 2(1-4) vs 4(3-6) days (P = 0.03). Average cost on levosimendan group was 14,792€ while the average cost per patient without levosimendan was 17,007€. Patients with no complications represented 53.8% of the total in the levosimendan arm, as compared to 31.7% in the non-levosimendan arm. In all Montecarlo simulations for sensitivity analysis, use of levosimendan was less expensive and more effective.
conclusionsPreconditioning with levosimendan, is a cost-effective strategy preventing postoperative low cardiac output in patients with moderate-severe left ventricular systolic dysfunction undergoing elective coronary artery bypass graft surgery.
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