{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T21:59:35Z","timestamp":1757627975635,"version":"3.44.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Levosimendan is a calcium-sensitizing inotrope with vasodilatory properties, shown to improve cardiac output and reduce mortality in adults with advanced heart failure. However, data on its safety and efficacy in neonatal cardiac surgery are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the intraoperative use of levosimendan in neonates with complex congenital heart defects (CHDs) undergoing open-heart surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective observational study of 59 neonates aged 2\u201330 days who underwent surgical correction of complex CHDs with cardiopulmonary bypass. Levosimendan was administered intracoronarily as part of the blood cardioplegia protocol in doses of 25\u201345 mcg\/kg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to historical controls, the levosimendan group demonstrated a significant reduction in postoperative catecholamine requirements, including adrenaline and norepinephrine. In 12% of cases, surgery was completed without the use of any catecholamines. No rhythm disturbances were observed. The positive inotropic effect lasted up to 72 h without systemic hypotension. Median adrenaline doses were significantly lower (p\u2009&amp;lt;\u20090.05), and norepinephrine use was reduced from 12% to 5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intracoronary administration of levosimendan during neonatal cardiac surgery appears to reduce catecholamine dependence and support myocardial recovery without causing rhythm disturbances or hypotension. Further randomized controlled trials are needed to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1577847","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T05:24:33Z","timestamp":1757481873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cIntracoronary levosimendan in neonatal cardiac surgery: a retrospective study on hemodynamic effects and catecholamine-sparing outcomes\u201d"],"prefix":"10.3389","volume":"12","author":[{"given":"Talgat","family":"Ibraev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulmira","family":"Zhauarova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amangeldi","family":"Kerimkulov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamilla","family":"Rakhimova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erlic","family":"Sungkarbekov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ijcard.2011.07.022","article-title":"Levosimendan: molecular mechanisms and clinical implications","volume":"159","author":"Papp","year":"2012","journal-title":"Int J Cardiol"},{"key":"B2","first-page":"39","article-title":"Efficacy and safety of the inotropic drug levosimendan in patients with acute myocardial infarction with Q-wave and acute heart failure","volume":"15","author":"Pavlikova","year":"2006","journal-title":"Clin Pharmacol Ther"},{"key":"B3","first-page":"3","article-title":"Levosimendan or dobutamine in acute heart failure?","volume":"18","author":"Moiseev","year":"2009","journal-title":"Clin Pharmacol Ther"},{"key":"B4","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1007\/s00431-008-0834-7","article-title":"First experiences with intraoperative levosimendan in pediatric cardiac surgery","volume":"168","author":"Osthaus","year":"2009","journal-title":"Eur J Pediatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1159\/000314955","article-title":"Acute effects of levosimendan on cerebral and systemic perfusion and oxygenation in newborns: an observational study","volume":"99","author":"Bravo","year":"2011","journal-title":"Neonatology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1097\/PCC.0b013e3182455571","article-title":"Levosimendan versus milrinone in neonates and infants after corrective open-heart surgery: a pilot study","volume":"13","author":"Lechner","year":"2012","journal-title":"Pediatr Crit Care Med"},{"key":"B7","first-page":"579","article-title":"Levosimendan in critically ill neonates and children: current evidence and practical recommendations","volume":"17","author":"Amigoni","year":"2007","journal-title":"Paediatr Anaesth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1186\/s13054-020-02880-2","article-title":"Early postoperative use of levosimendan in children after congenital heart surgery: a prospective randomized trial","volume":"24","author":"Namachivayam","year":"2020","journal-title":"Crit Care"},{"key":"B9","first-page":"e149","article-title":"Levosimendan in neonates and children: systematic review and meta-analysis","volume":"16","author":"Ricci","year":"2015","journal-title":"Pediatr Crit Care Med"},{"key":"B10","first-page":"80","article-title":"Experience of using levosimendan in patients with acute heart failure in myocardial infarction and decompensated chronic heart failure","volume":"18","author":"Yakupov","year":"2009","journal-title":"Clin Pharmacol Ther"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1577847\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T05:24:36Z","timestamp":1757481876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1577847\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":10,"alternative-id":["10.3389\/fcvm.2025.1577847"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1577847","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,10]]},"article-number":"1577847"}}