Gastrointestinal complications after cardiac surgery : eight years experience in a single center

The aim of this study was to evaluate the frequency of gastrointestinal complications (GICs) and associated risk factors in patients after cardiac surgery, and to stratify them according to the risk of developing GICs in order to improve our diagnostic protocols.

A total of 5959 patients who underwent cardiac surgery within a period of 97 months were retrospectively evaluated. Surgical procedures included coronary artery bypass grafting, heart valve surgery, aortic surgery, surgical correction of adult congenital heart defects, or combined procedures.

The frequency of GICs was 1.3% (75 patients). Intestinal ischemia and upper or lower gastrointestinal bleeding were the most common GICs. From 27 patients affected by intestinal ischemia, 21 patients were previously treated with intra-aortic balloon pump (p < 0.001). Low cardiac output, renal failure or dysfunction, renal risk, peripheral arterial disease, history of myocardial infarction, male gender, intra-aortic balloon pump, cardiopulmonary bypass time, aortic cross-clamp time, duration of intubation, SIRS, and MODS were associated with significantly increased risk of GICs.

To decrease the occurrence of intestinal ischemia, we suggest that placement of intra-aortic balloon pump should be preceded by examination of the descending aorta to rule out severe atherosclerotic changes, in which case -alternative cardiac support should be attempted.