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

• Published in: BMC anesthesiology 2022-05, Vol.22 (1), p.135-135, Article 135
• Main Authors: Li, Ze-Shi, Wang, Kuo, Pan, Tuo, Sun, Yan-Hua, Liu, Chang, Cheng, Yong-Qing, Zhang, He, Zhang, Hai-Tao, Wang, Dong-Jin, Chen, Zu-Jun
• Format: Article
• Language: English
• Subjects: Acute Disease; Analysis; Atrial fibrillation; Cardiac patients; Cardiac surgery; Cardiac Surgical Procedures - adverse effects; Cardiotonic Agents; Care and treatment; Cerebral infarction; Cohort analysis; Complications; Coronary artery bypass; Coronary artery bypass grafting; Dopamine; Drug dosages; Ejection fraction; Female; Fibrillation; Health aspects; Heart; Heart attack; Heart attacks; Heart surgery; Hemodynamics; Hospitals; Humans; Hydrazones - therapeutic use; Hypertension; Kidneys; Levosimendan; Male; Mechanical ventilation; Mortality; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Observational studies; Patients; Postoperative; Postoperative complication; Postoperative Complications; Postoperative infection; Propensity Score; Prospective Studies; Pyridazines - therapeutic use; Rupture; Septic shock; Simendan; Stroke (Disease); Surgery; Sutures; Ventricle; Ventricular septal rupture; Ventricular Septal Rupture - drug therapy
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-022-01663-z

The purpose of the present study was to evaluate the efficacy of levosimendan in patients with acute myocardial infarction related ventricular septal rupture (AMI-VSR) underwent cardiac surgery. Prospective observational cohort study with propensity score analysis. There were 261 patients with AMI-VSR in our study. After 1:1 propensity matching, 106 patients (53 levosimendan and 53 control) were selected in the matched cohort. None. Patients who received levosimendan were assigned to the levosimendan group (n = 164). The patients who were not received were levosimendan assigned to the control group (n = 97). The levosimendan was initiated immediately after cardiopulmonary bypass. Then, it has been maintained during the postoperative 3 days. The poor outcomes were identified as follows: death and postoperative complications (postoperative stroke, low cardiac output syndromeneeded mechanical circulatory support after surgery, acute kidney injury (≥ stage III), postoperative infection or septic shock, new developed atrial fibrillation or ventricular arrhythmias). Before matching, the control group had more length of ICU stay (6.69 ± 3.90 d vs. 5.20 ± 2.24 d, p