Gastrointestinal Complications After Cardiac Surgery

Abstract

Background: Gastrointestinal (GI) complications occur after 0.4-2.9 of cardiac surgery procedures. Although infrequent, GI complications constitute some of the most serious complications of cardiac surgery with a high associated morbidity and mortality rate of 14-63. In this study, we aimed to determine the incidence of and the risk factors for GI complications following open=heart surgery. Methods: In this retrospective study, 800 adult patients who underwent valvular surgery, coronary artery bypass grafting (CABG), combined procedures, aortic surgery, and the surgical correction of adult congenital heart defects in Rajaie Cardiovascular, Medical, and Research Center between April 2014 and May 2016 were studied. The clinical data on any GI complication-including its incidence, characteristics, diagnostic measures, mortality, and medical or surgical management-were retrospectively analyzed. Statistical analysis was performed using a non-paired Student t-test and the chi(2) test. Results: A total of 800 patients underwent open cardiac surgery: 340 (42.5) had CABG, 290 (36.3) had valve surgery, 120 (15) had combined procedures (valve surgery + CABG), 15 (1.9) had aortic surgery, and 35 (4.3) had congenital defect correction. Among these patients, GI complications were seen in 36 patients, with an incidence rate of 4.5. The total mortality rate was 11.1. Our results revealed that advanced age, a prolonged cardiopulmonary bypass time, prolonged mechanical ventilation, a history of peptic ulcer, and the use of inotropic support or intra-aortic balloon pumps were the risk factors for GI complications after cardiac surgery. Conclusions: GI complications following cardiac surgery have a low incidence rate but high morbidity and mortality rates. Primary detection and prompt appropriate intervention are essential for the outcome of the patients.