Is Levosimendan Superior to Milrinone Regarding Acute Kidney Injury After Cardiac Surgery for Congenital Heart Disease?

Inclusion Criteria

• Provision of informed consent prior to any study specific procedures
• Female and male children between 1 and 12 months of age
• Non-restrictive VSD (corrective surgery)
• Complete AVSD (biventricular repair)
• Tetralogy of Fallot

Exclusion Criteria

• Unbalanced AtrioVentricular Septal Defect or AVSD with cyanosis
• Age less than one month and more than one year
• Acute operation that is unscheduled operation during the first 24 hours after presentation to the department for thoracic surgery
• Mild, moderate, or severe kidney dysfunction and known anatomical anomalies of kidneys
• Liver impairment or disease
• Ongoing infection
• Use of nephrotoxic drugs (like ibuprofen, angiotensin-converting-enzyme inhibitors, gentamicin, vancomycin) preoperative or postoperative until first post operative day. Contrast agents whithin 24 hours before operation.
• Use of inhibitors of membrane transport proteins (cimetidine, cetirizine, trimethoprim, probenecid, rifampin and gemfibrosil).
• Allergy to Levosimendan or substance included in the preparation or previous use of Levosimendan.
• Severe arrhythmias needing pace-maker treatment prior to the operation
• Severe cardiac dysfunction needing for treatment with extracorporeal membrane oxygenation (ECMO) prior to the operation.
• Preoperative need for mechanical ventilation and/or inotropic agents.
• Re-operation (open heart surgery). Earlier surgical closure of the arterial duct does not count as an exclusion criteria.
• Prematurity: Gestational age < 30 weeks, irrespective of postpartum age. Gestational age 30-34 weeks if patient is included at postpartum age under 3 months.