Objective: Large number of comprehensive studies has been carried out on levosimendan. There are many studies on its use, especially in cardiac dysfunction, ischemic cardiac surgery, and heart transplantation surgery. But, there are limited number of studies regarding its use in mitral valve interventions and ischemic mitral dysfunction combined with coronary artery by-pass surgery (CABG). We aimed to investigate the efficacy of levosimendan usage on patients undergone combined coronary artery by-pass grafting and mitral valve surgery because of ischemic mitral dysfunction.