Purpose: gastrointestinal complication (GIC) following open heart surgery usually are rare but with high morbidity and mortality. The aim of this study was to see the outcome of these patients after complication, compared with a similar study found in literature. Identifying risk factors preoperatively and postoperatively in our patient’s series, for GIC.Materials and methods: Between January 2012 and December 2017 from 1990 operated cardiac patient 34 of them developed GIC, presenting gastro duodenal bleeding due to active ulcer, liver failure, pancreatitis, cholecystitis, or intestinal ischemia. We performed a retrospective analysis.Results: From all consecutive patient only 1.7 % developed GIC. Mortality rate was 55.8%, especially 100 % mortality in intestinal ischemia patient. Regarding risk factors, those were the same found in other similar study (age, atherosclerosis disease, by pass time, postoperative ARF, Low cardiac output syndrome.)Conclusion: GIC after cardiac surgery are rare but when it happens the mortality is very high not even of late diagnosis. In ages patients, diabetes, long by pass time, long hypoperfusion state. It is recommended to be alert for GIC for detection in early phase, and for reducing as much as possible morbidity and mortality.
An 11-year-old male was admitted with cough and fever for the last 4 days and also complained of pain in the right lung for some weeks. The boy did not show any other symptoms and his past medical history was unremarkable as well. The radiologist findings showed an aspect that suggested for echinococcosis. At first, it was realised the heart intervention. About a 2-month period later, the child underwent another cyst removal in lung. He had begun taking albendazole 5 days before the heart intervention. The therapy was continued until the lung intervention and for 12 weeks post-operatively. The patient had an uneventful recovery and after about 4 years.
Introduction: In open heart surgery such as Coronary artery Bypass Grafting, valve repair or replacement, or some congenital heart disease, patients are connected to the Cardiopulmonary bypass machine [1]. Cardiopulmonary bypass machine pumps the blood around the body while the heart is stopped and provides a bloodless field during cardiac surgery. Since an extracorporeal circuit is incorporated to the patient, there are observed abnormal physiological events during Cardiopulmonary bypass. These events include hemodilution, interstitial fluid accumulation, complement activation and depression of immune system. Cardiopulmonary bypass is associated with an acute phase reaction of protease cascades, leucocyte, and platelet activation that result in tissue injury [2, 3] and limited functional reserve. For many years was believed that Cardiopulmonary bypass under hypothermia is much safer. The main reason for “cooling body” is to protect the brain, heart and organs during cardiopulmonary bypass through reducing body metabolic rate [4]. During more recent years, according to many studies, it is shown that Cardiopulmonary bypass under Normothermia has much more advantages compared to Moderate Hypothermia. The aim of this study was to compare and examine which method has advantages in terms of clinical outcome, morbidity and mortality. Patients and methods. 60 patients were selected, who were scheduled for Coronary artery Bypass Grafting x 3, were enrolled in this study. Results: According to the primary variables (Troponin I, Lactic Acid) and also secondary variables of our study, resulted that Cardiopulmonary bypass in Normothermia has superiority compare to Moderate Hypothermia in patients that underwent Coronary artery Bypass Grafting. Conclusion: According to our data and literature [15, 16, 17], we concluded that Cardiopulmonary bypass in Coronary artery Bypass Grafting under Normothermia has advantages vs Moderate Hypothermia and Troponin I and Lactic Acid are very good biomarkers that show us if heart and organs perfusion/protection is adequate during this procedure.
Introduction; Trauma is the leading cause of death in United States in the younger population. National Trauma Data Bank in 2017 reported that 140 000 Americans dies and 80 000 are permanently disabled as a result of trauma each year. Cardiac trauma is identified in less than 10% of all trauma admissions but is associated with a much higher mortality than other organ system injuries. Considering the lethality of this type of injury, better guidelines should exist to direct management. We have analyzed data from pub med, surgery books, reviews and original presentations from many institutions to present actuality in management strategies of cardiac injuries. Cardiac injuries are classified penetrating and blunt. Penetrating trauma includes stab or guns wounds. All patients with a penetrating wound anywhere near the heart should be considered to have a cardiac injury. The penetrating cardiac traumas is a surgical emergency while the blunt injuries treatment consists mainly in observation. With early aggressive management only 1/3 of patient that arrive at hospital can be saved and this number can arise to more than 70 % if the patient survives until operating room. The results of treatment depend from infrastructural health system to the clinical presentation of the patients. Penetrating cardiac wounds mortality varies 5 % to 76 %. Blunt cardiac injuries are encountered mostly during motor vehicle accidents. The incidence of cardiac injuries in blunt trauma is 2.3-4.6 %. Overall mortality varies 11.4-24.5 %. Myocardial contusion is the most frequent type of blunt cardiac injuries. The diagnose of the cardiac trauma include: clinical assessment, physical examinations, chest radiographs, echocardiography, cardiac enzymes, ECG, CT scan and even chest drainage. Despite many diagnostic tools we have, it is very important the right management of these tools and the time. Conclusion: The surgery teams should be familiar with the management of the cardiac injuries and continuing education about this topic is the success key to manage better these emergencies.
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