Comparative study between uses of levosimendan versus intra-aortic balloon pump in high risk patients undergoing beating heart coronary artery bypass surgery

Authors

1 Departments of Anesthesia and Intensive Care Al-Azhar University, Egypt

2 Departments of Anesthesia and Intensive Care Faculty of Medicine, Al-Azhar University, Egypt

3 Department of Clinical Pathology2, Faculty of Medicine, Al-Azhar University, Egypt

4 Departments of Anesthesia and Intensive Care, Al-Azhar University, Egypt

Abstract

Background: Patients undergoing coronary artery bypass surgery (CABG), preoperative left ventricular insufficiency has been linked to increase mortality and morbidity. Intra-aortic ballon pump (IABP) helped high-risk cardiac patients during surgery to stabilize the hemodynamics. However, there are some drawbacks to balloon installation. Levosimendan, a newly developed medication, is now frequently utilised as an inotropic support without increasing the myocardium oxygen demand. Objective: Our study compared the effectiveness of levosimendan against intra-aortic balloon pump in candidates having beating heart CABG and whom had reduced left ventricular function and ejection fraction below 35 percent. Subjects and Methods: A prospective randomized clinical trial whereas 50 patients undergoing elective multi-vessel beating heart CABG shared and equally distributed to two groups, each includes 25 patients. The first called Levosimendan group, the second called IABP group. The hemodynamics, the biochemical markers, post surgical intensive care unit (ICU) admission data and in-hospital fatality were also compared between these two groups. Results: In comparison to the IABP group, the Levosemindan group shows decreased ICU stay and in hospital stay while maintaining similar hemodynamic functions, mechanical ventilation times, and death rates. Conclusion: In comparison to IABP, levosimendan infusion is a wise decision and a respectable alternative. Levosimendan use is comparable to IABP and decreases ICU and hospital stays for high-risk cardiac patients, when it comes to enhancing hemodynamics during and after beating heart CABG.

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