Safety and Effectiveness of Tolvaptan Administration after Total Arch Replacement

Yasunori Iida, Akihiro Yoshitake, Hideyuki Shimizu

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Postoperative fluid overload in cardiovascular surgery is associated with increased mortality and morbidity. Recently, tolvaptan (TLV), a selective vasopressin V2 antagonist, has been used for perioperative fluid management. This study aimed to validate the safety and effectiveness of TLV administration after total arch replacement (TAR) using selective cerebral perfusion. Methods: From August 2016 to December 2016, 11 patients who had undergone TAR for thoracic aortic aneurysm were included in this study. In addition to the conventional diuretics furosemide (20 mg) and spironolactone (25 mg), TLV (7.5 mg) was administered orally. Results: TLV increased urine output 1-3 days after administration. Body weight was gradually and steadily reduced until discharge. Neither renal nor liver dysfunction was recognized during the TLV administration. Conclusion: The concomitant use of TLV and conventional diuretics is safe and effective for fluid management after TAR using cardiopulmonary bypass, selective cerebral perfusion, and hypothermic circulatory arrest.

Original languageEnglish
Pages (from-to)103-107
Number of pages5
JournalAnnals of Vascular Surgery
Publication statusPublished - 2019 Apr

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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