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Year : 2020  |  Volume : 33  |  Issue : 4  |  Page : 1388-1392

Levosimendan vs intra-aortic balloon pump in low ejection fraction coronary artery bypass grafting patients

Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Ahmed H Onsi
Department of Cardiothoracic Surgery, Menoufia Faculty of Medicine, Yassin Abdel Ghaffar Street from Gamal Abdel Naser Street, Shebin ElKom, Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_84_20

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Background Coronary artery bypass grafting (CABG) surgery in poor left ventricular function patients is still risky with much postoperative comorbidity that mandates trials to find the best management protocol to cure those patients safely. The authors aimed at evaluating the postoperative outcome of preoperative prophylactic use of levosimendan vs intra-aortic balloon pump (IABP) in those patients. Patients and methods In all, 90 patients presented with coronary insufficiency with an ejection fraction of less than 35% and underwent CABG. They were divided into three groups: group A (30 patients) who did not receive preoperative prophylactic support with neither IABP nor levosimendan; in group B (30 patients) IABP was inserted with induction of anesthesia; and in group C (30 patients) levosimendan was administered intravenously through the central line after induction of anesthesia. The authors followed postoperative hemodynamics and morbidities during hospital stay till discharge. Results Group C had significantly lesser ICU stay than other groups. Groups B and C had significantly lower needs of postoperative inotropic supports than group A. However, mortality and other major morbidities were similar among the three groups. Conclusion Patients with prophylactic preoperative support with IABP or levosimendan had the same postoperative outcome as patients without preoperative support in a situation of CABG with low ejection fraction. However, this prophylactic use add a value of lower needs of postoperative inotropes and moreover levosimendan is associated with lesser ICU stay.

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