{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:07:30Z","timestamp":1787170050983,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Maintaining a low left atrial pressure (LAP) in off-pump coronary artery bypass grafting (OPCAB) is desirable. This study was done to compare the effects of intravenous levosimendan or milrinone on LAP at different stages of OPCAB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>After institutional ethics committee clearance, this two-arm double-blind randomized control trial was done in 44 adult patients with triple vessel coronary artery disease undergoing OPCAB at cardiac OT of IPGME&amp;R, Kolkata. The patients were randomly allocated into two groups receiving intraoperative either levosimendan or milrinone. Pulmonary capillary wedge pressure (PCWP) was compared as the primary outcome parameter, whereas other echocardiographic and hemodynamic parameters were also assessed during six stages of OPCAB, that is, after sternotomy, proximal(s), left anterior descending artery (LAD), obtuse marginal (OM), posterior descending artery (PDA) grafting, and before sternal closure. Numerical parameters were compared using Student\u2019s unpaired two-tailed t-test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      PCWP was found to be significantly lower (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) in the levosimendan group during proximal (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.047), LAD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018), OM (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001), PDA grafting (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028), and before sternal closure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015). Other parameters indicate LAP, that is, from mitral early diastolic inflow velocity to mitral annular early diastolic velocity ratio (E\/e\u2019), which indicated significantly lower LAP in levosimendan group during LAD, OM, and PDA grafting and before sternal closure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Levosimendan may be used as a primary inotrope in terms of better reduction in left atrial pressure during different stages of OPCAB, translating to a decrease in left ventricular end-diastolic pressure, therefore maintaining optimum coronary perfusion pressure, which is the primary goal of the surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_51_23","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T05:01:23Z","timestamp":1697259683000},"page":"411-417","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Intravenous Levosimendan or Milrinone on Left Atrial Pressure in Patients Undergoing Off-Pump Coronary Artery bypass Grafting\u2014A Prospective Double-Blind, Randomized Controlled Trial"],"prefix":"10.4103","volume":"26","author":[{"given":"Abhinandan","family":"Mondal","sequence":"first","affiliation":[{"name":"Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kakali","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep Kumar","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavan Kumar","family":"Dammalapati","sequence":"additional","affiliation":[{"name":"Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaitali S.","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, 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