Abstract
BackgroundTo summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB).MethodsA total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed.ResultsOf all the patients, 33(1.4%) developed abdominal complications postoperatively, including 11(33.3%) cases of paralytic ileus, 9(27.3%) of gastrointestinal haemorrhage, 2(6.1%) of gastroduodenal ulcer perforation, 2(6.1%) of acute calculus cholecystitis, 3(9.1%) of acute acalculus cholecystitis, 4(12.1%) of hepatic dysfunction and 2(6.1%) of ischemia bowel diseases. Of the 33 patients, 26 (78.8%) accepted medical treatment and 7 (21.2%) underwent subsequent surgical intervention. There were 5(15.2%) deaths in this series, which was significantly higher than the overall mortality (2.7%). Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications.ConclusionsAbdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.
Highlights
To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB)
A history of gastrointestinal ulcer diseases was present in 9 patients, 59 patients were classified in NYHA class IV, and 6 patients needed preoperative intra-aortic balloon pump (IABP) support
The operations associated with abdominal complications after CPB included reparation of congenital ventricular septal defect (1, 3.0%), correction of congenital double outlet of right ventricle and tetralogy of Fallot (6, 18.2%), modified Fontan procedures and total cavopulmonary connections (3, 9.1%), coronary bypass grafting (3, 9.1%), valve replacement (9, 27.3%), aortic aneurysm replacement (3, 9.1%), Batista operation (1, 3%) and combined surgery
Summary
To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB). Abdominal complications following cardiopulmonary bypass (CPB) have been reported since the early days of cardiac surgery. Despite improvements in surgical techniques and perfusion technologies, the incidence and mortality have not decreased during the last two decades. It remains a significant problem in the clinical practices. Diagnosis and aggressive treatment is the key to successfully reduce mortality [1]. The clinical assessment is often difficult because these patients may be sedated, mechanically ventilated, partially unresponsive, and that the usual symptoms and signs may be masked by severe cardiac and pulmonary conditions.
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