Gastrointestinal Complications following Cardiac Surgery: A Comprehensive Review

Rodríguez, Roberto; Robich, Michael P.; Plate, Juan F.; Trooskin, Stanley Z.; Sellke, Frank W.

doi:10.1111/j.1540-8191.2009.00985.x

Cited by 74 publications

(100 citation statements)

References 68 publications

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“…These physical characteristics of infant bowels, when combined with reduced intestinal blood flow during extracorporeal circulation and postoperative low cardiac output syndrome or mesenteric vascular contraction induced by a sudden increase in blood pressure, are risk factors for gastrointestinal complications (12,13). The cause of postoperative bowel perforation in patients with congenital cardiac disease is gastrointestinal ischemic anoxic injury, due to low cardiac output syndrome (14). Among the patients evaluated in the present study, those with Tetralogy of Fallot had been exhibiting hypoxia for a long period of time, which affected the growth of the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 91%

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

et al. 2018

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Abstract. The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case). The age range of the children was 6-11 months and the weight range was 7.3-8.6 kg. Furthermore, these children underwent radical surgery under general anesthesia and extracorporeal circulation in low temperatures. Abdominal symptoms appeared 4-10 days after surgery, and included poor appetite, abdominal distension, intermittent vomiting, high fever, refractory irritability, crying and shortness of breath. One case was confirmed by routine abdominal puncture and the remaining two were confirmed by the detection of free gas under the diaphragm, as revealed by abdominal X-ray. Following the diagnosis of intestinal perforation, emergency intestinal fistula surgery was performed. At 3-5 days post-surgery, the patients underwent treatment by fasting and intravenously administered parenteral nutrition.

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Section: Discussionmentioning

confidence: 91%

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

et al. 2018

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“…178 Risk factors include advanced age, diabetes, renal failure, cerebrovascular disease, postoperative low cardiac output, and CPB time >98 minutes. 179Ͳ180…”

Section: Upper Gastrointestinal Bleedingmentioning

confidence: 99%

“…190,191 Although the mortality rate of hyperbilirubinemia is 4%, one literature review found the mean mortality of actual liver failure to be 56%. 178 Causes of perioperative liver dysfunction include preoperative heart failure and resulting liver congestion, hemolysis from either CPB, the use of operative field suction, or prosthetic valves, blood transfusion, hypoxia, or reperfusion injury. End-stage Liver Disease) Score is used to predict three month mortality.…”

Section: Hepatic Dysfunction and Failurementioning

confidence: 99%

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Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient

Szelkowski¹,

Puri²,

Singh³

et al. 2015

Current Problems in Surgery

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“…Intestinal ischemia is often caused by a malperfusion of the upper mesenteric artery and is one of the most common gastrointestinal complications following cardiac surgery, although it occurs only with a probability of 0.16% of all cardiac operations [2, 9, 10]. Nevertheless, it is of utmost importance to find an adequate therapy because the mortality is higher than 50% [10].…”

Section: Introductionmentioning

confidence: 99%

Effect of Glycine, Pyruvate, and Resveratrol on the Regeneration Process of Postischemic Intestinal Mucosa

Brencher

Petrat

Stych

et al. 2017

BioMed Research International

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Background Intestinal ischemia is often caused by a malperfusion of the upper mesenteric artery. Since the intestinal mucosa is one of the most rapidly proliferating organs in human body, this tissue can partly regenerate itself after the onset of ischemia and reperfusion (I/R). Therefore, we investigated whether glycine, sodium pyruvate, and resveratrol can either support or potentially harm regeneration when applied therapeutically after reperfusion injury. Methods I/R of the small intestine was initiated by occluding and reopening the upper mesenteric artery in rats. After 60 min of ischemia and 300 min of reperfusion, glycine, sodium pyruvate, or resveratrol was administered intravenously. Small intestine regeneration was analyzed regarding tissue damage, activity of saccharase, and Ki-67 positive cells. Additionally, systemic parameters and metabolic ones were obtained at selected periods. Results Resveratrol failed in improving the outcome after I/R, while glycine showed a partial beneficial effect. Sodium pyruvate ameliorated metabolic acidosis, diminished histopathologic tissue injury, and increased cell proliferation in the small intestine. Conclusion While glycine could improve in part regeneration but not proliferation, sodium pyruvate seems to be a possible therapeutic agent to facilitate proliferation and to support mucosal regeneration after I/R injury to the small intestine.

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Gastrointestinal Complications following Cardiac Surgery: A Comprehensive Review

Cited by 74 publications

References 68 publications

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient

Effect of Glycine, Pyruvate, and Resveratrol on the Regeneration Process of Postischemic Intestinal Mucosa

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