Gastrointestinal complications after cardiac surgery

Yılmaz, Ahmet; Arslan, Mehmet Tayyip; Demirkilç, U; Özal, Ertuğrul; Kuralay, Erkan; Bingöl, Hakan; Oz, Bilgehan Savas; Tatar, Harun; Öztürk, Ömer

doi:10.1016/s1010-7940(96)80337-x

Cited by 75 publications

(57 citation statements)

References 10 publications

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“…[1][2][3][4][5][6][7][8] In our study, the incidence of GI complications in patients undergoing mitral valve surgery was 2.3% with a 30-day mortality of 39%, both of which consistent with existing reports. Valvular surgery was suggested to correlate with higher incidence of GI complications both by univariate [9][10][11][12][13] and multivariate 3,14) analysis, and our incidence is in agreement with this observation.…”

Section: Discussionsupporting

confidence: 89%

“…Low flow state often requires placement of IABP which has been identified as a determining factor for abdominal complications in both multivariate 7,14,17) and univariate studies. 2,3,6,8,10,13,20) In our analysis, although postoperative IABP use was significantly more common in the GI complications group by univariate analysis ( Table 1), its impact after logistical regression analysis was not significant.…”

Section: Discussionmentioning

confidence: 53%

“…6,8,10,20) Valve surgery that requires anticoagulation often increases bleeding. In our series, surgical intervention was not required for isolated GI bleeding; surgery was required only when there was an additional GI complication (ischemic bowel or acute cholecystitis).…”

Section: Discussionmentioning

confidence: 99%

“…In many of the early published series, acalculous cholecystitis is more prevalent 10,[25][26][27] just like it is in our study group, although there are many reports where there is a mixed presence of calculous and acalculous disease. 6,8,20) In conclusion, GI complications following isolated or concomitant mitral valve surgery are rare but lethal complications requiring high index of suspicion for GI complications should be considered in patient with conditions of hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…However, mortality in these patients is high, ranging from 11%-70% in various studies. [1][2][3][4][5][6][7][8] Multiple published reports have examined GI complications after cardiac surgery in general. This represents a heterogeneous group of pathologies.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Gastrointestinal Complications after Mitral Valve Surgery

Gulkarov

Trocciola

Yokoyama

et al. 2014

Ann Thorac Cardiovasc Surg

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Introduction: Gastrointestinal (GI) complications are well-recognized risks of open heart surgery. However, open heart surgery comes in different shapes and sizes with widely varying pre-operative, intra-operative and post-operative pathologies. The aim of this study was to examine the etiology and risk factors for GI complications after mitral valve surgery. Methods: A retrospective analysis of 565 patients who underwent mitral valve surgery from 2003-2005 was performed. Prospectively collected data included preoperative risk factors, cardiac status, intra-operative data, postoperative GI complications and mortality. Survival was analyzed using log-rank analysis. Results: In this study population, 13 patients (2.3%) had 16 GI complications after mitral valve surgery resulting in an overall mortality of 0.7%. Complications included GI bleed (n = 9), cholecystitis (n = 3), perforated diverticulitis (n = 1) and ischemic bowel (n = 3). By univariate analysis, a history of hypertension, chronic renal insufficiency (CRI), hypercholesterolemia, myocardial infarction, congestive heart failure, cardiogenic shock, emergency valve surgery, coronary artery bypass surgery and preoperative vasopressor use were each associated with an increased incidence of GI complications (p <0.05). No increased incidence was seen in patients with atrial fibrillation. On multivariate analysis adjusted for age, cardiogenic shock (OR 8.1; 95% CI, 1.9-34.8), CRI (OR 8.1; 95% CI, 2.2-30.0) and vasopressor use (OR 6.5; 95% CI, 1.3-31.0) remained significant (p <0.02). Mean survival (3.2 vs. 5.4 years) was significantly lower (p <0.05) in those with GI complications. Conclusions: GI complications after mitral valve surgery are infrequent, with a higher incidence in those with cardiogenic shock, CRI or requiring vasopressors. Pre-operative hemodynamic instability may be a bellwether for potential GI complications and should be of more prominent concern in this cohort of patients.

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