The use of novel inotropes is increasing due to the increasing side effects of older inotropes including epinephrine, dobutamine; these side effects include arrhythmias and increasing cardiac oxygen consumption. The aim of this study was to compare the effect of the novel Ca++ sensitizer levosimendan with milrinone which is a phosphodiestra inhibitor on cardiac function and pulmonary artery pressure during congenital heart surgery for repair of VSD or A-V canals associated with pulmonary hypertension.