Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background: In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitizer and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favorable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. Patients and methods: This prospective non randomized study was performed at Kasr El-Ainy Hospitals, CairoUniversity in Egypt in the period between May 2018 and February 2019. The study was previously approved by the Ethics Committee for Clinical Research of the institutions. Forty patients, women and men, all patients presented with coronary insufficiency confirmed by coronary angiographic studies and Pre-operative echocardiography revealed poor left ventricular function Ejection fraction less than 35%.The patients were allocated into two groups of 20 in Group A patients will be submitted to 24 hours pre-operative Levosimendan and Group B patients will be submitted to Levosimendan with induction of anesthesia

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