Intermittent levosimendan treatment for late onset right ventricular failure in a patient supported with a left ventricular assist device

Levosimendan, a calcium sensitizer, functions as a positive inotrope without increased myocardial oxygen consumption, and due to its long half-life, its positive inotropic effects persist for at least 1 week and its hemodynamic/neuro-humoral effects last for up to 4 weeks.4 In our case, intermittent low-dose levosimendan could have increased the contractility of RV and effectively dilated the PA, with subsequent decreasing of the afterload of the right ventricle. This may have restored adequate LV filling pressures and LVAD flow. Further investigation is needed to ensure the value of intermittent levosimendan in patients on LVAD support, where RVF could be very burdensome with high mortality and morbidity.