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Impact Of Using LevosemidanVersus DobutamineOn Right Ventricular Function In AdultPatients Undergoing Elective Valve Replacement Surgery

NCT07416331 — Completed, 52 participants, Helwan University

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RegistryNCT07416331, acronym rt side failur
StatusCompleted
Study typeObservational
Enrollment52 (Actual)
SponsorHelwan University (Other)
ConditionsRight Ventriculaire Dysfunction, Pulmonary Hypertension
Datesstart 2024-08-01, primary completion 2025-08-01, completion 2025-08-01, first posted 2026-02-18, last updated 2026-02-18
Locations1 site in Egypt

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-Summary

in this prospective, randomized, controlled double blinded study conducted at Helwan University Hospitals include 52 patients with rheumatic mitral and/or aortic valve disease and pulmonary arterial hypertension at the start of rewarming, patients will be randomly assigned into either group 1 (levosimendan) or group 2 (dobutamine ) Group 1 patients will receive dobutamine, 3-5 microgram/kg group 2 patients will receive levosimendan 6 ug/kg bolus over 10 minutes, followed by infusion at a rate of 0.1 mg/kg/min Transthoracic echocardiography performed before induction of anaesthesia (baseline), 6 and 12 hours post surgery . In addition, transthoracic echocardiography also performed 24 hours post extubating. Transoesophageal echocardiography (TEE) examination performed during the intraoperative period before the initiation of CPB (pre CPB) and 30 minutes after separation from CPB (post-CPB) Echocardiographic parameters measured will include tricuspid annular plane systolic excursion (TAPSE), Tei index and myocardial systolic velocities at the tricuspid annulus (S/) for the assessment of right ventricular systolic function, and ratio of tricuspid inflow to tricuspid annular diastolic velocity (E/E/) for the assessment of right ventricular diastolic function.

Pulmonary artery pressure will be assessed frequently by transthoracic echo during every assessment.

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+Arms and interventions

ArmTypeInterventionsDescription
group 1(levosimendan)group 1 (levosimendan) Group 1 will receive levosimendan 6 ug/kg bolus over 10 minutes, followed by infusion at a rate of 0.1 mg/kg/min
Group 2 (dobutamine)r group 2 (dobutamine ) Group 2 patients will receive dobutamine, 3-5 microgram/kg group

+Outcome measures

Primary outcomes

  • post operative change of right ventricular function during 1 week after surgery mesured by ECHO parameters [from enrollment to the end of treatment at 1 week]: echocardiographic parameters include ,TAPSE( tricused annular plane excursion in cm) , Tei index, myocardial systolic velocities at the tricuspid annulus S/in cm/s , ratio of tricuspid inflow to tricuspid annular diastolic velocity (E/e/) those parameters will be combined for the assessment of right ventricular function.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age ≥18 years
* Undergoing mitral and/or aortic valve replacement
* PAH (an estimated right ventricular systolic pressure more than 50 mmHg, or mean PAP more than 40 mmHg, or systolic PAP exceeding 50% of systemic systolic pressure).

Exclusion Criteria:

* Potential pregnancy.
* Refusal to participate.
* Patients with severe renal dysfunction (GFR 15 to 29 ml/min per 1.73 m2 )
* Severe hepatic dysfunction.( Grade 4: AST/ALT >20.0 x(upper limit normal )
* Prolonged QT interval.
* Emergency surgery,
* Requiring preoperative inotropes.
* Uncontrolled diabetes mellitus (HBA1C more than 8 )

+Locations (1)

FacilityCityCountryStatus
Helwan UniversityGizaEgypt

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