[Cases of successful treatment of heart failure after cardiac surgeries]

Low cardiac output syndrome (LCOS) is a leader in the structure of complications and mortality in patients after cardiac and vessels surgery. LCOS causes circulatory hypoxia. Opportunity to use of new inotropic drug draws attention of anaesthesiologists, and ICU physicians of cardio-surgical centers. Levosimendan (SIMDAX, Orion Farmina, Finland) is a only calcium sensitiser, pyridazinone-dinitrile derivative with additional action on adenosine triphosphate (ATP)-sensitive potassium channels. Most important effects are increasing of contractile ability of the heart and veins dilatation both to arteries.

Two patients with mitral heart disease were included in the study. The patients undergone mitral valve replacement (MVR) complicated with LCOS. The original condition of the first patient was critical. Purposes of the patient's hospitalization were haemodialysis and intensive care. Diuresis of the patient resumed after the haemodialysis. However heart failure increased and the patient received an urgent mitral valve replacement. Levosimendan infusion was started in order the low cardiac output. The second patient had a critical reduction of the left ventricular ejection fraction (LVEF) after MVR. Levosimendan infusion was repeated in 3 days. In both cases Levosimendan use had positive effect on LVEF, haemodynamics and the duration of artificial lung ventilation and stay in the ICU.