Gastrointestinal complications following cardiac surgery

Abstract

Gastrointestinal complications after cardiac surgery may be uncommon but they carry high mortality rates. Incidences range from 0.5% to 5.5%, while mortality rates of such complications vary from 0.3% to 87%. They range from small gastrointestinal bleeds, ileus, and pancreatitis to life-threatening complications such as liver failure and ischemic bowel. Due to the vague and often absence of specific signs and symptoms, diagnosis of a gastrointestinal complication is often late. This article aims to review and summarize the literature concerning gastrointestinal complications after cardiac surgery. We discuss the causes, risk factors, diagnosis, preventative measures, and management of these complications. In general, risk factor identification, preventive measures, early diagnosis, and swift management are the keys to reducing the occurrence of gastrointestinal complications and their associated morbidity and mortality.

Gastrointestinal complications after cardiac surgery: Incidence, predictors, and impact on outcomes

“…Gastrointestinal (GI) complications are uncommon, but potentially highly morbid events following cardiac surgery procedures 1 . The reported incidence of these events is between 0.5% and 4.5% of cardiac cases, but the in‐hospital mortality associated with GI complications is around 30%–40%, with some series reporting higher rates of mortality 2–8 . Previous series have identified several risk factors such as increasing age and comorbidity, as well as and prolonged operation times as risk factors for the development of GI complications 3,4,7 .…”

Experience in curing refractory gastrointestinal bleeding due to type A aortic dissection combined with mesenteric artery malperfusion: a case report

“…A m o n g t h e d i v e r s e b u t i n t e r r e l a t e d r e a s o n s f o r gastrointestinal complications after cardiac surgery, visceral hypoperfusion is considered to be the main one. Despite the low incidence of gastrointestinal complications after cardiac surgery (0.5-5.5%), they may lead to a mortality rate of as high as 87% (1).…”

The correlation between bowel complications and cardiac surgery

“…The GI organs receive 20%–25% of the body’s cardiac output and accounts for 20% of the oxygen needs in a healthy person. The main blood supply to these organs include the coeliac artery (which supplies the liver, stomach, abdominal esophagus, spleen, superior duodenum, and superior pancreas), superior mesenteric artery (which supplies the distal duodenum, jejuno-ileum, ascending colon, and part of the transverse colon) and inferior mesenteric artery (which supplies the large intestine from the splenic flexure to the upper part of the rectum), all of which branch from the abdominal aorta (12).…”

“…They are then investigated by looking at levels of serum amylase or lipase and using a computerized tomography (CT) scan. Management of these patients is often conservative using nasogastric drainage, fluid resuscitation, and analgesia (12). The incidence of acute pancreatitis varies from 0.05% to 19% depending on the type of cardiac surgery.…”