Comparison of Levosimendan Versus IABP in Patients with Poor Left Ventricular Function Undergoing Coronary Artery Bypass Graft Surgery.

Abstract

The aim of this study was to compare the use of levosimendan versus intra-aortic balloon pump (IABP) in patients with poor left ventricular function undergoing coronary artery bypass grafting (CABG) with ejection fraction less than 35%. Between February 2016 and March 2019, a prospective randomized study was performed on a group of 279 consecutive patients with left ventricular ejection fraction < 35%, who underwent elective CABG without concomitant procedures. These patients were divided into 2 groups, according to the treatment they received - either levosimendan (Group A) or intra-aortic balloon counterpulsation (Group B). There was no statistically significant difference between the 2 groups, regarding mortality and morbidity. In the IABP group, the mean arterial blood pressure (2 hours post cardiopulmonary bypass) significantly was higher, and the heart rate in postoperative Day 1 significantly was lower. The levosimendan group had a significantly lower ICU stay than the IABP group. We found that starting levosimendan infusion after induction of anesthesia is an acceptable option in comparison to IABP. The use of levosimendan in high-risk cardiac patients is comparable to IABP in improving hemodynamics during and after conventional on-pump CABG and results in a shorter ICU stay.