Quality of life in patients with low ejection fractions after various methods of myocardial revascularization on the open heart

Kharitonov N. V., Golubeva K. S., Vitsukayev V. V., Trofimov N. A., Makalskiy P. D., Zavgorodniy V. N.

Purpose of the study. To study the effect of levosimendan infusions as a preoperative preparation before myocardial revascularization surgery in patients with reduced left ventricular ejection fraction, as well as on left ventricular remodeling processes and changes in overall myocardial contractility in the postoperative period. Material and methods. A comprehensive retrospective analysis of data from 313 patients who underwent coronary bypass surgery (OPCAB or CABG) from 2008 to 2018 was performed. The patients were divided into two groups: 1st control group - patients with myocardial revascularization without treatment with Levosimendan (n= 190 patients). 2nd study group - patients with myocardial revascularization with preoperative preparation with Levosimendan (n= 123 patients).Results. Left ventricular ejection fraction significantly increased in the postoperative period in patients in both groups (p < 0.05), however, in the group using levosimendan, the increase in LV ejection fraction after surgery was higher (p < 0.027). Also, in the study group, norepinephrine and dopamine infusion in the postoperative period was required much less frequently than in the control group. (p< 0.05).Based on the analysis of mortality in the two groups in the early postoperative period, it turned out that in the group where levosimendan was used, the mortality was zero, while in the other group, the mortality was 9 people (p = 0.013). The volume parameters of the heart chambers in the postoperative period decreased in both groups, however, in the group with levosimendan infusion, this indicator was significantly higher. (p< 0.05).

Keywords:coronary artery bypass grafting, levosimendan, low ejection fraction, ischemic heart disease.