Early Outcomes and Effectiveness of Tolvaptan for Management after Cardiovascular Surgery

Takuya Misato, Satoshi Tobe, Ryo Toma, Hironobu Sugiyama, Kazuma Okamoto, Taro Hayashi

Akashi Medical center, department of cardiovascular surgery, Akashi city, Japan

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – B

Abstract

Objective

Fluid management is one of the important factor in early term after cardiovascular surgery. In many cases, some diuretics are administered for volume therapy. To assess effectiveness of Tolvaptan, the latest vasopressin type 2 receptor antagonist for management after cardiovascular surgery.

Methods

From April 2016 to September 2016, 13 patients introduced Tolvaptan to manage fluid condition in early period after cardiovascular surgery. In same period, 54 patients who underwent cardiac surgery without introduction of Tolvaptan made as control group. We assessed effect of Tolvaptan to compare about perioperative parameters such as change of body weight, duration of ventilator support, hospital stay and renal function. Results

About preoperative characteristics, NYHA class was higher (2.46 vs 1.87) and morbidity rate of renal dysfunction was more (92.3% vs 61.1%) in Topvaptan group. Operative procedures and parameters were not different significantly in both groups. Although mechanical ventilator support time was significantly longer in Tolvaptan group, hospital stay was similar in both groups. In Tolvaptan group preoperative creatinine was higher (1.34 vs 0.98), and peak creatinine in post operative term was much higher (1.77 vs 1.17). But creatinine at discharge was 1.12 and 0.90 respectively, there was no significant difference in both groups.

Conclusions

Although patients who was introduced Tolvaptan in early postoperative period had tendency of heart failure and suffering from renal impairment before cardiac surgery, they got safe discharge with same hospital stay and without worsening renal function. We consider that Tolvaptan was more helpful for patient of cardiovascular surgery suffering from heart failure or renal dysfunction before intervention.