Impact of Perioperative Levosimendan on Patients Undergoing Cardiac Surgery with Low Ejection Fraction

Background: Levosimendan is regarded as the best inotropic substance to promote heart health.  It has a lusitropic effect and increases cardiac output with a little increase in myocardial oxygen consumption due to its pharmacodynamics.
Objective: Levosimendan impact on patients undergoing coronary artery bypass surgery alone, valve alone and combined surgery with low ejection fraction less than 35%.
Patients and Method: Retrospective randomized study done at Cardiothoracic Surgery Department, Zagazig University, Egypt, January 2021 - October 2024. Each group of the three main groups was subdivided in to two groups; levosimendan group and traditional inotropes group.
Results: Levosimendan in coronary artery bypass grafting (CABG) alone, combined, valve alone: had statistically significant difference in some variables of primary outcomes and secondary outcomes, but in valve alone: significant difference in some variables of secondary outcomes and single variable of primary outcomes, however hypotension and atrial fibrillation showed significant difference in the all studied groups
Conclusion: Levosimendan has many positive outcomes post cardiac surgery in patients with low ejection fraction. Differential effect based on pathophysiology mechanisms more obviously on ischemic rather than pressure or volume cardiomyopathy.