• Daniel Hoefer, Patrycja Jonetzko, Christoph Hoermann, Guenther Laufer, and Gerhard Poelzl.
• Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria. daniel.hoefer@uibk.ac.at
• Wien. Klin. Wochenschr. 2006 Feb 1; 118 (1-2): 60-2.

AbstractAortic valve replacement in patients suffering from low-gradient aortic stenosis and congestive heart failure is associated with high operative mortality, and the perioperative use of inotropes is common. Levosimendan is a calcium sensitizer with positive inotropic and vasodilatory effects and has been developed for treatment of decompensated heart failure. Although its use in patients with low-gradient aortic stenosis is not established, we hypothesized that it might have beneficial effects on outcome after aortic valve replacement. We report on a high-risk operation in a 73-year-old man with low-gradient aortic stenosis, congestive heart failure and coronary artery disease. Levosimendan was administered perioperatively (0.1 mg/kg/min 16 hours prior to the operation without a loading dose) and allowed rapid recovery of the patient, who required only brief treatment in the intensive care unit. No levosimendan-specific adverse events were observed, in particular no hypotension. The excellent postoperative result was maintained after the patient was discharged from hospital.

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