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Objectives: This study aims to compare the efficacy and short-term clinical outcomes of levosimendan versus intra-aortic balloon pump (IABP) in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Patients and methods: This prospective, randomized-controlled study included a total of 60 patients (44 males, 16 females; mean age 60.58+5.23 years; range, 42 to 70 years) with low left ventricular ejection fraction (<25%) undergoing OPCABG between January 2019 and September 2019. The patients were divided into two groups as levosimendan (Group L) and IABP (Group B). Hemodynamic parameters were measured at prespecified time points. Results: Hemodynamic data recorded at baseline were comparable in both groups, while cardiac index progressively increased in both groups. Although, the increase was statistically significant on multiple measures analysis of variance in both groups, no significant difference was observed at different time points. Pulmonary capillary wedge pressure decreased in both groups; however, the decline was not statistically significant. Serum lactate concentration was consistently lower in Group B compared to Group L at all time points. The heart rate, mean arterial pressure, and Vasoactive Inotropic Score (VIS) were comparable in both groups at all time points. The mean length of intensive care unit (ICU) stay was statistically significant in Group B compared to Group L. Conclusion: The use of prophylactic levosimendan is comparable to prophylactic IABP, when hemodynamic parameters are considered. Prophylactic levosimendan is associated with a shorter length of hospital and ICU stay. Prophylactic levosimendan can be considered an alternative to prophylactic IABP in patients with low ejection fraction in whom IABP is contraindicated.

cardiovascular surgery and interventions

Comparison of prophylactic levosimendan versus intra-aortic balloon pump for off-pump coronary artery bypass grafting in patients with low ejection fraction: A randomized-controlled trial