Laparatomy due to gastrointestinal complications after open heart surgery

Abdominal complications following open heart surgery remain rare but fatal events with mortality rates of 14.5% up to 100%. Manifestations and managements of these complications are varying. Approximately, 25% of patients with gastrointestinal complications require surgical management with obviously higher mortality risks. The aim of this study was to determine the perioperative prognostic factors of gastrointestinal complications with surgical consequences after cardiac surgery.

The study enrolled 15.737 patients who underwent open heart surgery between January 2002 and September 2007. Sixteen (0.1%) persons required laparatomy due to postoperative gastrointestinal complications. Additionally, the preoperative, operative, and postoperative risk factors for this condition were studied.

Among the patients enrolled, 15.737 patients underwent open heart surgery while 16 (0.1%) required laparatomy procedures due to gastrointestinal complications. They were comprised of 11 (68.8%) men and 5 (31.3%) women at a mean age of 62.88±12.56 years. There was a history of hypertension in 9 (56.3%) patients, hypercholesterolemia in 11 (68.8%), renal failure in 4 (25%), previous CABG in 2 (12.5%) and PTCA in 2 (12.5%). Morbidity and mortality were significantly higher in this group of patients with a mortality rate of 68.8% (68.8% versus 1.6%).

Our multivariate logistic regression model identified the following parameters to be the prognostic factors for gastrointestinal complications with surgical consequences: a history of previous CABG, previous PTCA, preoperative renal failure, preoperative anticoagulant agent use, valve surgery, combined valve and CABG surgery, and intra-aortic balloon pump requirement with OR of 51.95, 4.623, 26.436, 0.140, 5.43, 11.469 and 3.76, respectively.