Does off-pump CABG reduce gastrointestinal complications?

Sanisoglu, Ilhan; Güden, Mustafa; Bayramoğlu, Zehra; Sağbaş, Ertan; Dibekoglu, Cengiz; Sanisoğlu, S. Yavuz; Akpınar, Belhhan

doi:10.1016/j.athoracsur.2003.08.006

Cited by 47 publications

(37 citation statements)

References 27 publications

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“…Another possible reason may be that CPB time in our study was rather long (132.4±50.8 min) compared with that in other studies (83.5-124 min) 10,13,23. Prolonged CPB is associated with higher incidence of complications2,9,10 because long duration of CPB causes prolonged reduction in pancreatic blood flow, resulting in pancreatic acinar cell injury 3. For these reasons, our data showed higher incidence of post-operative pancreatitis.…”

Section: Discussionmentioning

confidence: 59%

Clinical Implications and Risk Factors of Acute Pancreatitis after Cardiac Valve Surgery

Chung

Ryu

et al. 2013

Yonsei Med J

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PurposeAcute pancreatitis is one of the potentially lethal complications that occurs after cardiac surgery. We tried to identify risk factors for and the prognosis of acute pancreatitis after cardiac valve surgery with cardiopulmonary bypass.Materials and MethodsWe retrospectively analyzed a database of consecutive patients who underwent cardiac valve surgery with cardiopulmonary bypass between January 2005 and April 2010 at our institution. Patients were classified as having acute pancreatitis based on serum lipase concentration and clinical symptoms (lipase ≥180 U/L or ≥60 U/L with relevant symptoms).ResultsOf the 986 patients who underwent cardiac valve surgery with cardiopulmonary bypass, 58 (5.9%) patients developed post-operative pancreatitis. Post-operative hospital stay was significantly longer (29.7±45.6 days vs. 12.4±10.7 days, p=0.005) and in-hospital mortality rate was higher (15.5% vs. 2.0%, p<0.001) in patients with post-operative pancreatitis than those without. Hypertension, chronic kidney disease, and peri-operative use of norepinephrine were identified as independent risk factors for developing pancreatitis after cardiac valve surgery.ConclusionWe found that acute pancreatitis after cardiac valve surgery requires longer hospitalization and increases the in-hospital mortality rate. Clinicians should be aware that patients could develop pancreatitis after cardiac valve surgery, especially in patients with hypertension and chronic kidney disease treated with norepinephrine.

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Section: Discussionmentioning

confidence: 59%

Clinical Implications and Risk Factors of Acute Pancreatitis after Cardiac Valve Surgery

Chung

Ryu

et al. 2013

Yonsei Med J

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“…A similar pH pattern is also observable for mucous intestinal tissue and intestinal villus (5). On the other hand, mesenteric ischemia is a catastrophic complication of CABG that can be caused by various conditions such as older age, intraaortic balloon pulsation implantations, perioperative hypotension, arrhythmia, metabolic acidosis, mesenteric atherosclerosis, thromboembolism during CPB and vasopressor medications (6). Furthermore, gastrointestinal bleeding is the most frequent postoperative complication.…”

Section: Discussionmentioning

confidence: 93%

Ogilvie syndrome: a rare but lethal intestinal complication of coronary revascularization

Yurtman¹,

Talay²,

Dalga³

et al. 2012

Anadolu Kardiyol Derg

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“…Sanisoglu et al showed that the incidence rates of GI complications were similar in the on-and off-pump coronary artery bypass groups, the type of GI complications, however, was different. CPB did not emerge as a risk factor for GI complications, but prolonged CPB (longer than 98 minutes) resulted in a high incidence of such complications [14]. Further research in this area will be required in order to clarify these results.…”

Section: Discussionmentioning

confidence: 98%

“…Off pump CABG has been promoted by many cardiothoracic surgeons as better than on pump CABG in terms of reduced neurological complications, decreased morbidity and mortality, and renal dysfunction [12]. The impact of CPB on the development of GI complications has been studied with varied results [13,14]. Sanisoglu et al showed that the incidence rates of GI complications were similar in the on-and off-pump coronary artery bypass groups, the type of GI complications, however, was different.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Gastrointestinal Complications on Patients who Undergo Coronary Artery Bypass Grafting

Lemaire¹

2014

J Cardiovasc Dis Diagn

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Objective: The incidence of gastrointestinal (GI) complications in patients undergoing coronary artery bypass grafting (CABG) is increasing as the population ages. The reported incidence ranges from 0.3% to 3.7%. Coronary Artery Bypass Grafting (CABG) is one of the most common operations performed. The outcome of patients who undergo abdominal operations for GI complications after CABG is not known. The purpose of the study is to determine the impact of abdominal surgery on patients who undergo CABG. Methods:A retrospective review of nationwide data of all patients undergoing CABG from 2006 to 2010. A total of 160,513 patients who underwent CABG were reviewed.Results: A total of 236 patients out of the 160,513 patients who underwent CABG developed GI complications that required abdominal surgery. The abdominal procedures included small and large bowel resections as well as colostomy formation. The indications for abdominal surgery varied and included ischemic bowel, and bowel obstruction. The patients who underwent concomitant abdominal surgery were more likely to develop renal Confidence Interval (CI) (8.5 to 14.2) (P<0.0001), respiratory CI (8.5 to 14.8) (P<0.0001), and infectious CI (16.3 to 28.6) (P<0.0001) complications. They were also more likely to have higher mortality CI (16.2 to 29.0), (P<0.0001). Patients who underwent abdominal operations had longer length of stay (LOS) 37.23 ± 32.8 days versus 8.2 ± 6.1 days (P<0.0001) and higher hospital charges, $389,586 ± 2 60,546 compared to $111,290 ± 82,462.2 (P<0.0001). Conclusion:Although rare, the impact of abdominal surgery resulting from GI complications is significant. The patients who had abdominal surgery and underwent CABG were more likely to develop multiple complications. As a result, these patients had a higher rate of mortality, longer LOS, and higher hospital costs. Taken together, these results indicate that patients with GI complications should be identified promptly and aggressively treating these patients is of paramount importance.Citation: Lemaire A, Batsides G, Ghaly A, Solina A, Dombrovsky V, et al. (2014) The Impact of Gastrointestinal Complications on Patients who Undergo Coronary Artery Bypass Grafting. J Cardiovasc Dis Diagn 2: 153.

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Does off-pump CABG reduce gastrointestinal complications?

Cited by 47 publications

References 27 publications

Clinical Implications and Risk Factors of Acute Pancreatitis after Cardiac Valve Surgery

Clinical Implications and Risk Factors of Acute Pancreatitis after Cardiac Valve Surgery

Ogilvie syndrome: a rare but lethal intestinal complication of coronary revascularization

The Impact of Gastrointestinal Complications on Patients who Undergo Coronary Artery Bypass Grafting

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