Document Detail

Levosimendan: a promising treatment for myocardial stunning?
MedLine Citation:
PMID:  16409345     Owner:  NLM     Status:  MEDLINE    
We report a case of a 55-year-old male undergoing major orofacial cancer surgery. A stent to the left anterior descending artery had been implanted for ischaemic heart disease 3 years previously. Twenty-four hours after uneventful anaesthesia and surgery, the patient developed myocardial infarction and cardiogenic shock. Immediate percutaneous transluminal coronary angioplasty, intra aortic balloon counterpulsation, and catecholamine therapy failed to stabilise haemodynamics. In light of successful reperfusion therapy and an only moderate elevation of troponin I, myocardial stunning rather than myonecrosis was considered to be the major contributor to life-threatening left ventricular failure. Therefore, the calcium-sensitising drug levosimendan, which exerts positive inotropic activity without increasing myocardial oxygen demand, was administered as a rescue medication. Within 24 h, levosimendan resulted in decreased filling pressures, reduced left ventricular end-diastolic volume, and augmented systemic pressures. Seven days following surgery, the patient was discharged from the intensive care unit in good clinical condition.
B M Ellger; P K Zahn; H K Van Aken; C Schmidt; T Brussel
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  61     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-13     Completed Date:  2006-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  61-3     Citation Subset:  AIM; IM    
Department of Anaesthesiology and Surgical Intensive Care Medicine, University of Muenster Hospital, D-48129 Muenster, Germany.
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MeSH Terms
Cardiotonic Agents / therapeutic use*
Facial Neoplasms / surgery
Hydrazones / therapeutic use*
Middle Aged
Myocardial Ischemia / complications
Myocardial Stunning / drug therapy*
Postoperative Complications / drug therapy*
Pyridazines / therapeutic use*
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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