Acute heart failure is a common clinical problem faced in cardiac surgery operating rooms and intensive care units. Levosimendan, an inotropic and vasodilating agent used widely in cases of acute heart failure for "cardiological" patients, has not gained global acceptance in its application for heart-operated ones. Herein, we are presenting a series of studies and patents concerning this medication, which, in general, support the use of levosimendan during and after heart surgery, despite the relatively high cost of administration. However, trials with larger samples of patients have to be performed in order to definitively establish this medication as a routinely administered drug for acute congestive heart failure after heart surgery.