الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Congenital heart diseases (CHDs) are the most common congenital anomalies worldwide. Closure of large cardiac shunts and cardiopulmonary bypass (CPB) in patents with preexisting pulmonary hypertension is challenging. Many inodilator drugs are used in their management as milrinone and levosimendan. Transesophageal echocardiography can be a useful monitor in these patients.Methods: This study was conducted on (50) patients of either sex who had elective correction of congenital heart diseases associated with pulmonary hypertension using cardiopulmonary bypass. The patients are divided into 2 equal groups, levosimendan group (n=25) who received intravenous levosimendan 12 μg/kg i.v Over 10 minutes after cross clamp removal followed by 0.1μg/kg/min for 24h max and milrinone group (n=25) who received i.v milrinone 50μg/kg of bolus dose over period of 10 minutes and then 0.5μg/kg/min infusion. In both groups transesophageal echocardiography was used to measure systolic pulmonary artery pressure SPAP. All hemodynamics were recorded basal, pre-bypass, immediately after bypass, 10 minutes after bypass, 1 hour and 24 hours postoperative. Results: SPAP were lower in levosimendan group than milrinone group. Mean blood pressure and cardiac functions were higher in levosimendan group. Also patients’ recovery and discharge from ICU and hospital were earlier in the levosimendan group.Conclusion: levosimedan is better than milrinone as an inodilator in managing pulmonary hypertention in pediatric patient undergoing corrective cardiac surgeries.