Assessing the effectiveness of Levosimendan Use and Intra-Aortic Balloon Pump Use in Controlling Postoperative Complications in Patients Undergoing Coronary Artery Bypass Graft Surgery with Low Ejection Fraction: A Comparative Study

Document Type : Original Article

Authors

Department of Cardiothoracic Surgery, Faculty of Medicine, Suez Canal University, Suez Canal, Egypt.

Abstract

Introduction: Coronary artery bypass grafting (CABG) is done for prognostic as well as symptomatic purposes. Even though it has been demonstrated that decreased myocardial function can recover following CABG, left ventricular contractile dysfunction is still a risk factor for poor postoperative outcome. Positive inotropy, vasodilation, and cardiac cytoprotection are the three main modes of action of the inotropic medication levosimendan. Levosimendan and/or its active metabolite has also been shown to provide cardioprotection during acute and chronic heart failure by reducing myocardial remodeling, inflammation, ischemia-reperfusion damage, and myocyte death. The purpose of this study was to assess the effectiveness of levosimindan against an intra-aortic balloon pump in controlling complications and lowering death rates in patients after CABG surgery with low ejection fraction sixty days after surgery.
Methods: The study was conducted at Cardiothoracic Surgery Department; Suez Canal University, it was a comparative prospective randomized study and the sample included 50 patients undergoing CABG operation with poor LV function (less than 40%) divided into two groups, Group A including patients administered levosimendan I.V. infusion and Group B included patients having IABP insertion.
Results: The current results showed that there was no statistically significant difference between both studied groups concerning demographic data, as regards Preoperative hemodynamic parameters, there was also no statistically significant difference between both studied groups. As for postoperative complications, there was no statistically significant difference between both studied groups. Regarding Sixty-day survival, there was no statistically significant difference between both groups.
Conclusion: Prophylactic levosimendan can be considered an alternative to prophylactic IABP in patients with low ejection fraction in whom IABP is contraindicated. The use of prophylactic levosimendan is comparable to the use of prophylactic IABP when risk and rate of complications are estimated in both approaches.

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The Egyptian Journal of Surgery
Volume 44, Issue 1
January 2025
Pages 106-117

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