Prophylactic Use of Levosimendan in High-Risk Coronary Artery Disease: Retrospective Clinical Research

ABS TRACT Objective: To investigate the perioperative and postop- erative effects of preoperative levosimendan use in coronary artery patients with low ejection fraction (EF) (<40%). Material and Methods: A total of 6,571 coronary bypass patients who were treated at Kartal Ko ş uyolu High Specialization Training and Research Hospital between 2016 and 2019 were scanned, and 132 patients with preoperative EF below 40% were retrospectively analyzed. The patients were divided into 2 groups as those who received preoperative levosimendan (Group 1: 90 patients) and the control group, who did not receive it at all (Group 2: 42 patients). All of the patients included in the study were on- pump coronary bypass patients and excluded off-pump bypass, emergency bypass, and other concomitant procedures. Results: In terms of EF values, improvements over time were significantly different in favor of Group 1 (p<0.043). The duration of the intensive care unit stay in Group 1 was longer (p<0.047). The changes in patients in terms of postoperative venous oxygen saturation over time were found to be statis- tically positive in favor of Group 1 (p<0.042). Mortality was observed in 5 patients in the postoperative early period (first 30 days), all of whom were from Group 1. However, no statistical difference was observed. Conclusion: Preoperative use of levosimendan in coronary artery patients with low EF improved some hemodynamic parameters; however, it did not make a significant hemodynamic and clinical contribution to surgery success in high-risk patients.