Cardiac surgery with the use of cardiopulmonary bypass is a common procedure, with more than one million operations performed in the United States and Europe each year. Studies show that 3 to 14 percent of patients who undergo this type of procedure experience a complication known as the low cardiac output syndrome; prevention of this syndrome is an important therapeutic objective for the improvement of outcomes in this patient population.
Duke Anesthesiology’s Dr. Jerrold Levy co-authored an article published on March 19, 2017 in the New England Journal of Medicine, titled “Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery.”
Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. In a multicenter, randomized, placebo-controlled, phase 3 trial, investigators evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35 percent or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass.
The authors concluded that prophylactic levosimendan did not result in a rate of the short-term composite end point of death, renal-replacement therapy, perioperative myocardial infarction, or use of a mechanical cardiac assist device that was lower than the rate with placebo among patients with a reduced left ventricular ejection fraction who were undergoing cardiac surgery with the use of cardiopulmonary bypass.
This study was presented at the Late Breaking Clinical Trials Session of the American College of Cardiology on March 19, 2017.