Abdominal complications after heart surgery with cardiopulmonary bypass

Yaroustovsky, M.B.; Abramyan, Marina; Назаров, Н. С.; Komardina, Ekaterina; Волкова, С.С.

doi:10.24022/1810-0694-2018-19-3-318-326

Cited by 2 publications

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“…Abdominal complications in patients who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) are rare (1.1%) but associated with high mortality, which reaches 90%[ 1 , 2 ]. Predicting the risk of their development may be one of the ways to solve this problem.…”

Section: Introductionmentioning

confidence: 99%

Risk score for predicting abdominal complications after coronary artery bypass grafting

Belov

Garbuzenko

Abramovskikh

et al. 2020

WJC

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BACKGROUND Although early abdominal complications after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) are rare, the associated mortality remains high. AIM To develop a risk score for the prediction of early abdominal complications after CABG with CPB. METHODS This retrospective study was performed in the Federal State Budgetary Establishment “Federal Center of Cardiovascular Surgery” of the Ministry of Health of Russia (the city of Chelyabinsk) and included data of 6586 patients who underwent CABG with CPB during 2011-2017. The risk factors taken for evaluation were compared between patients with early abdominal complications ( n = 73) and without them ( n = 6513). We identified the most important risk factors and their influence on the development of early abdominal complications after CABG with CPB. RESULTS Gender and the presence of postinfarction cardiosclerosis, chronic kidney disease, or diabetes in the anamnesis did not affect the occurrence of abdominal complications. The leading risk factors of the early abdominal complications after CABG with CPB were multifocal atherosclerosis, extracorporeal membrane oxygenation, intra-aortic balloon pump, atrial fibrillation, perioperative myocardial infarction, and the need for resternotomy in the postoperative period. The average value of the predicted probability was 0.087 ± 0.015 in patients with early abdominal complications after CABG with CPB and 0.0094 ± 0.0003 in patients without these complications. The percentage of correct classification turned out to be 98.9%. After calculating a score for each of the leading risk factors, we counted a total score for each particular patient. The highest risk was noted in patients with a total score of 7 or more. CONCLUSION The developed score predicts the risk of early abdominal complications after CABG with CPB and makes it possible to stratify patients by risk groups.

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Section: Introductionmentioning

confidence: 99%

Risk score for predicting abdominal complications after coronary artery bypass grafting

Belov

Garbuzenko

Abramovskikh

et al. 2020

WJC

View full text Add to dashboard Cite

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Intestinal protection by nitric oxide supply in the simulation of artificial blood circulation and circulatory arrest: an experimental study

Podoksenov,

Churilina,

Kamenshchikov

et al. 2024

Pulʹmonologiâ (Mosk.)

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Cardiac surgery is associated with high risks of complications, and these risks increase when it comes to aortic surgery because of the technical complexity of the surgeries, the use of cardiopulmonary bypass (CPB) and “circulatory arrest” (CA) that leads to ischemia-reperfusion damage. Abdominal complications in cardiovascular surgery are not the most common complications but are associated with high mortality. Protecting the gastrointestinal (GI) organs from ischemia-reperfusion injury is still a serious problem. According to a study of the organoprotective properties of nitric oxide (NO), its effectiveness in the treatment of diseases of the cardiovascular system, lungs, and kidneys has been proven, and observational results have shown that patients who were administered NO were less prone to complications from the gastrointestinal tract.The aim of the study was to evaluate the protective properties of NO for the intestines during simulated surgery under CPB and hypothermic CA. Methods. The study was conducted on sheep (n = 24). The animals were divided into 4 groups: the “CPB” group with the standard CPB protocol, the “CPB + NO” group with CPB and NO administration, the “CPB + CA” group with the standard CPB and CA protocol, and the group “CPB + CA + NO” with CPB and CA and NO administration. Instrumental and laboratory parameters were monitored at all stages of the experiment to assess the effectiveness and safety of CPB and CA simulation. In intestinal biopsy samples, the changes in the defecation rate, the concentration of a biochemical marker of intestinal ischemia (intestinal enterocyte fatty acid binding protein – i-FABP), and tissue concentrations of adenosine triphosphate (ATP) and lactate were assessed.Results. A higher rate of defecation was established (p = 0.046) in the “CPB + NO” group after CPB compared to the “CPB” group. The concentration of i-FABP in the CPB + NO group after CPB was lower compared to that in the CPB group (p = 0.002), and it was lower in the “CPB + CA + NO” group compared to the “CPB + CA” group (p = 0.033). 1 hour after CPB, the tissue concentration of ATP in intestinal biopsies in the “CPB + NO” group was higher than in the CPB group (p = 0.005).Conclusion. When modeling CPB and CA in the experiment, a positive effect of NO therapy on the intestine was noted: the functional state improved, the concentration of i-FABP decreased, and the concentration of ATP in intestinal biopsies increased.

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Abdominal complications after heart surgery with cardiopulmonary bypass

Cited by 2 publications

References 0 publications

Risk score for predicting abdominal complications after coronary artery bypass grafting

Risk score for predicting abdominal complications after coronary artery bypass grafting

Intestinal protection by nitric oxide supply in the simulation of artificial blood circulation and circulatory arrest: an experimental study

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