Pancreatic Complications Following Cardiopulmonary Bypass

Lefor, Alan T.; Vuocolo, Philip; Parker, Frederick B.; Sillin, Lelan F.

doi:10.1001/archsurg.1992.01420100087015

Cited by 32 publications

(20 citation statements)

References 21 publications

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“…The Forty-eight hour postoperative AST and AST/ALT ratio were lower in off-pump group, and ALT levels were similar in both groups. In patients undergoing on-pump coronary surgery, possible factors causing liver dysfunction may be the decrease in systemic vascular resistance, low CPB pressure, inflammatory activation and microemboluses (14,15). Fifty percent of patients undergoing CABG was shown to have temporary intestinal mucosal ischemia indicated by intramucosal acidosis.…”

Section: Discussionmentioning

confidence: 99%

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Bayram

Zor

Erer

et al. 2016

GMJ

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Objective: Cardiopulmonary bypass (CPB) triggers systemic inflammation. Inflammatory system activation may cause deteoriation in liver and renal functions. In our study we aimed to search the effect of on-pump CPB and beating heart off-pump coronary artery bypass grafting (CABG) surgery techniques on renal and liver functions. Methods: Sixty four patients who underwent coronary artery surgery were included in the study and were divided into two groups: on-pump CPB group (40) and beating heart off-pump CABG group (24), prospectively. The blood samples were collected for preoperative and postoperative levels of blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and AST to ALT ratio at 24 th and 48 th hours. Results: Clinical and demographic features were similar in both groups. There were no statistically significant difference in levels of preoperative BUN, creatinine, AST, ALT, AST to ALT ratio. The postoperative 24 th hour plasma levels of creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but BUN and ALT levels were similar among the two groups. The postoperative 48 th hour plasma levels of BUN, creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but levels of ALT were similar in both groups. Conclusion: Based on our findings we conclude that beating heart off-pump CABG has lower negative effect on liver and renal function than on-pump CPB. Abstract of this manuscript was presented in 7th Congress of Update in Cardiology and Cardiovascular Surgery in association with TCT Mediterranean as a poster.Key Words: Acute kidney injury, cardiopulmonary bypass, coronary artery bypass, coronary artery bypass, off-pump, liver. Anahtar Sözcükler: Akut böbrek hasarı, kardiyopulmoner bypass, koroner arter bypass, off-pump koroner arter bypass graftleme, karaciğer. ReceivedGeliş Tarihi:

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Section: Discussionmentioning

confidence: 99%

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Bayram

Zor

Erer

et al. 2016

GMJ

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“…The ischemic injury with consecutive reperfusion, so-called ischemia/ reperfusion (I/R) injury, is considered to be a potentially damaging factor in the initiation and progression of acute pancreatitis. 5) I/R injury of the pancreas has been observed in several clinical situations, such as shock, 6) cardiac or aortic surgery using cardiopulmonary bypass (CPB), 7) and pancreatic transplantation. 8) However, I/R injury of the pancreas, associated with acute aortic dissection, has not been fully recognized, and its precise incidence is unclear due to its rarity.…”

Section: Discussionmentioning

confidence: 99%

“…7) The pathogenesis of postcardiac surgical pancreatitis is associated with hypoperfusion of the whole pancreas caused by low cardiac output, prolonged bypass time, vasoconstrictor use, and hypothermia. 6,7) Hypoperfusion evoked by aortic dissection could be a common factor in the pathogenesis of ischemic pancreatitis between pancreatitis related to CPB and dissection. In our case, we speculated that I/R injury-induced acute pancreatitis, related to the ABAD, was caused by the sudden and transient deterioration of the pancreatic circulation, as a result of the dissected splenic artery.…”

Section: Discussionmentioning

confidence: 99%

Acute Ischemic Pancreatitis Associated with Acute Type B Aortic Dissection: A Case Report

Hamamoto

2012

Annals of Vascular Diseases

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A 47 year-old man, presenting with sudden back pain in the absence of abdominal discomfort, was diagnosed with acute type B aortic dissection which extended to the celiac and the splenic arteries. Antihypertensive treatment was initiated. However, he subsequently complained of upper abdominal pain with increased amylase levels. Computed tomography scan (CT) revealed new accumulation of peripancreatic fluid with no signs of further aortic or visceral dissection. A protease inhibitor was administered for mild acute pancreatitis. Follow-up CT demonstrated disappearance of thrombosed false lumen of the splenic artery and reduction of the effusion. The patient was discharged without any surgical interventions.

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“…19 They include ischemia due to cardiac surgery or aortic dissection, vasculitis derived from systemic lupus erythematosus or polyarteritis nodosa, and atheroemboli. [19][20][21][22][23] In this case, we could not identify the cause of the acute pancreatitis premortem. This case was not associatedwith bile stones, alcohol, drugs, some metabolic abnormalities, or carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol embolic disease presenting as renal failure with acute pancreatitis

Okada¹,

Saito²,

Tamura³

et al. 1997

Clin Exper Neph

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Renal failure and acute pancreatitis developed in a 63-year-old man after 2 angiography procedures and iliac artery surgery. The results of the renal biopsy showed no specific abnormalities and the cause of the pancreatitis could not be determined. The patient was treated with hemodialysis and conservative management for pancreatitis, however he died due to sepsis approximately 50 days after diagnosis. The autopsy revealed cholesterol crystals in several organs including the kidneys, pancreas, and spleen. Therefore, systemic cholesterol emboli may have contributed to the development of renal failure and acute pancreatitis in this case. Cholesterol crystals in the pancreas have frequently been observed at autopsy in patients with cholesterol emboli. The clinical development of acute pancreatitis, however, is quite rare in these cases. The present case is reported to increase awareness of the possible clinical presentations of systemic cholesterol embolic disease in an effort to increase the correct diagnosis of this condition.Clin Exper Nephrol 1997;1:136-141Key words: cholesterol embolism, acute renal failure, acute pancreatitisCholesterol embolic disease (CED) is a multisystem disorder caused by cholesterol crystal emboli in various organsJ -7 CED occurs predominantly in elderly men with atherosclerotic cardiovascular disease, and after angiographic procedures, vascular surgery, or anticoagulant therapy. The most common clinical presentations of CED are acute renal failure and cutaneous manifestations. It is usually difficult to diagnose premortem, and the mortality rate is high. Autopsies reveal cholesterol emboli in multiple organs including the pancreas, however, the clinical development of acute pancreatitis is extremely rare in CED. We describe a case of CED presenting as renal failure with acute pancreatitis, which was diagnosed histologically after the patient's death. CASE REPORTA 63-year-old man with a 14-year history ofhypertension was admitted for treatment of arteriosclerosis obliterans (ASO) in August 1995. He had intermittentReceived Sep. 12, 1996; revised Jan. 20, 1997; accepted for publication in revised form Feb. 27, 1997. *Correspondence and requests for reprints to: Department of Nephrology, Tokyo Medical College, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160, Japan.claudication 3 years before admission, and smoked a pack of cigarettes daily for 40 years. He previously drank alcohol regularly for many years, but had not drunk excessively in recent years. On admission, his serum creatinine level was 0.9 mg/dL and his 24-hour creatinine clearance was 83.5 mL/min, with no abnormalities in urine sediment. His blood pressure was maintained within normal limits (systolic/diastolic, 120 to 140/70 to 80 mm Hg), by administration of 2 antihypertensive drugs. Aortography and coronary angiography showed stenosis of both external and internal iliac arteries on both sides, and the right coronary artery, respectively. Neither renal artery had extensive stenosis. To treat the right external iliac artery stenos...

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Pancreatic Complications Following Cardiopulmonary Bypass

Cited by 32 publications

References 21 publications

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Acute Ischemic Pancreatitis Associated with Acute Type B Aortic Dissection: A Case Report

Cholesterol embolic disease presenting as renal failure with acute pancreatitis

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