These risks have led to the appearance of several ways to provide better outcomes. These ways are either mechanical like intraaortic balloon pump (IABP) or using medical inotropic drugs either adrenergic (epinephrine, norepinephrine &dobutamine) or non-adrenergic (levosimendan) drugs. It is indicated for the short-term treatment of acutely
Patients and Method
Patients had collected, withpoor left ventricular function ejection less than or equal to 40%. Cases had allocated into two gatherings of 50 cases.cases had admitted to the cardiovascular intensive care unit (ICU) 24h before surgery, a peri-operative dose of continuous levosimendan infusion cases will be submitted to conventional inotropes only (non levosimendan gathering) according to their medical requirements.

Objective: to detect the outcome of clinical use of preioperative Levosemindan for cases undergoing coronary artery bypass grafting comparing it with the conventional medications as catecholamines.
Results
Gathering A included 38 cases received levosimendan Gathering B included 40 cases received conventional cardiac support. A critical difference between both gatherings regarding total operative time, total bypass time, failure of weaning from cardiobypass (C.P.B), the use of intraoperative I.A.B.P.. There had a statistically critical difference between both gatherings in which C.V.P had lower in levosimendan .There had statistically critical difference regarding base critical in the levosimendan gathering. with high statistical difference for medical support, no difference for support .
Conclusion
the use of levosimendan perioperative is useful than cathecholamins