Efficacy of a Proton Pump Inhibitor Given in the Early Postoperative Period to Relieve Symptoms of Hiatal Hernia After Open Heart Surgery

Abstract

Early postcardiotomy GFS confirmed a high incidence of type I hiatal hernia. However, the proton pump inhibitor given in the early postoperative period proved more effective than the H2-receptor antagonist for relieving GI symptoms and preventing upper GI disorders after cardiac surgery.

Is Prophylactic Intravenous Administration of a Proton Pump Inhibitor Necessary for Perioperative Management of Cardiac Surgery?

“…Previous studies have reported a 0.35% to 5.7% incidence of GI bleeding after cardiac surgery despite the use of prophylactic antacid agents other than PPIs [Halm 2000;van der Voort 2000;Hata 2005], albeit the patients' characteristics in these studies differed considerably. Although UGIE findings might have been present before surgery, the incidence of gastroesophagitis (including superficial gastritis, erosive gastritis, and esophagitis) was 30% in our study, which is within the previously reported range of 12.2% to 68.0% [Zacharias 2000;D'Ancona 2003;Hata 2005Hata , 2006]. Up to 52.5% of the patients had insidious gastroesophagitis and hiatal hernia, even during sufficient PPI therapy.…”

“…We conducted UGIE examinations in all patients to evaluate the postoperative status of the GI tract, regardless of the presence or absence of abdominal symptoms. Postoperative abdominal symptoms are occasionally subjective and can be attributed in part to mood disturbances caused by various types of physiological and psychological stresses [Hata 2006]. Some GI complications were not detected in our previous studies until UGIE examinations were performed [Hata 2005[Hata , 2006].…”

“…Postoperative abdominal symptoms are occasionally subjective and can be attributed in part to mood disturbances caused by various types of physiological and psychological stresses [Hata 2006]. Some GI complications were not detected in our previous studies until UGIE examinations were performed [Hata 2005[Hata , 2006]. Most upper GI complications occur within 7 days after cardiac surgery [Aranha 1984].…”

Cardiac compression following cardiac surgery due to unrecognised hiatus hernia

“…Correspondingly a sizeable proportion of patients coming for cardiac surgery have clinical history or radiological evidence of this abnormality. Once the presence of hiatus hernia is recognised, preventive steps can be taken to ensure a smooth postoperative recovery [8]. This also illustrates the fact that when a patient deviates from the norm a careful review of the chest X-ray must be performed and decompression of the stomach should be carried out promptly if hiatus hernia with gastric distension is noticed.…”

Incidence of Drug Interaction When Using Proton Pump Inhibitor and Warfarin According to Cytochrome P450 2C19 (CYP2C19) Genotype in Japanese

“…Proton pump inhibitors (PPIs) are the most effective treatment to prevent the gastrointestinal bleeding or gastroesophageal reflex disease after open heart surgery that affects the patient's postoperative quality of life. 1,2 However, patients undergoing heart surgery are usually administered warfarin (WF), which is associated with bleeding complications. We previously reported that one of the PPIs mainly metabolized by cytochrome P450 2C19 (CYP2C19) was associated with postcardiotomy bleeding events.…”