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Acute Mesenteric Ischemia and Splenic Infarct After Coronary Bypass Surgery: An Analysis of 32 Patients
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Research Article
VOLUME: 72 ISSUE: 2
P: 247-250
August 2019

Acute Mesenteric Ischemia and Splenic Infarct After Coronary Bypass Surgery: An Analysis of 32 Patients

J Ankara Univ Fac Med 2019;72(2):247-250
DOI: 10.4274/atfm.galenos.2019.29484
Çağdaş Baran 1
Mehmet Çakıcı 1
Evren Özçınar 1
Ali İhsan Hasde 1
Ömer Arda Çetinkaya 2
Serkan Durdu 1
Mustafa Bahadır İnan 1
Mustafa Şırlak 1
Ahmet Rüçhan Akar 1
1. Ankara Üniversitesi Tıp Fakültesi, Kalp Merkezi, Kalp ve Damar Cerrahisi Kliniği, Ankara, Türkiye
2. Ankara Üniversitesi Tıp Fakültesi, İbn-I Sina Hastanesi, Genel Cerrahi Kliniği, Ankara, Türkiye
No information available.
No information available
Received Date: 05.08.2019
Accepted Date: 05.08.2019
Publish Date: 02.10.2019
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ABSTRACT

Objectives:

Acute mesenteric ischemia and other end organ emboli are serious life-threatening complications after open-heart surgery. In this study, we evaluated the outcome of patients with mesenteric ischemia and splenic infarction after cardiac surgery.

Materials and Methods:

From January 2010 to November 2017, all patients (5607) who underwent open-heart surgery were analysed, and patients with registered acute mesenteric ischemia and splenic infarct (32) were retrospectively reviewed.

Results:

Five thousand six hundred and seven patients were included in this study, of which 32 (0.57%) patients suffered from acute mesenteric ischemia and splenic infarct. Intraoperatively, splenic infarction was detected in six patients who were pre-diagnosed as mesenteric ischemia. In these patients, the symptoms completely improved after the splenectomy and all the patients survived. Only two of 26 patients were survived after segmentary bowel resection. Overall mortality was 24 (%75). Age (p=0.03), need for dialysis (p=0.01), emergency cardiac operation (p=0.05), peripheral arterial disease (p=0.001), and high risk Euroscore (p=0.0001) were significantly different compared to the control group. Mesenteric ischemia was significantly higher in off- pump coronary artery bypass patients (p=0.0001). The time of cardiopulmonary bypass in mesenteric ischemia group was significantly higher than the control group (p=0.0001).

Conclusion:

Acute mesenteric ischemia is still highly mortal, after cardiac surgery. Splenic infarct symptoms may mimic mesenteric ischemia. Mesenteric ischemia is more common in high-risk cardiac operations. Prompt diagnosis and treatment can be life-saving.

Keywords: Mesenteric Ischemia, Splenic Infarction, Cardiac Surgery

References

1
Christenson JT, Schmuziger M, Maurice J, et al. Postoperative visceral hypotension the common cause for gastrointestinal complications after cardiac surgery. Thorac Cardiovasc Surg. 1994;42:152-157.
2
Zacharias A, Schwann TA, Parenteau GL, et al. Predictors of gastrointestinal complications in cardiac surgery. Tex Heart Inst J. 2000;27:93-99.
3
Mangi AA, Christison-Lagay ER, Torchiana DF, et al. Gastrointestinal complications in patients undergoing heart operation: an analysis of 8709 consecutive cardiac surgical patients. Ann Surg. 2005;241:895-901.
4
Bolcal C, Iyem H, Sargin M, et al. Gastrointestinal complications after cardiopulmonary bypass: sixteen years of experience. Can J Gastroenterol. 2005;19:613-617.
5
Filsoufi F, Rahmanian PB, Castillo JG, et al. Predictors and outcome of gastrointestinal complications in patients undergoing cardiac surgery. Ann Surg. 2007;246:323-329.
6
Acosta-Merida MA, Marchena-Gomez J, Hemmersbach-Miller M, et al. Identification of risk factors for perioperative mortality in acute mesenteric ischemia. World J Surg. 2006;30:1579-1585.
7
Schoots IG, Koffeman GI, Legemate DA, et al. Systematic review of survival after acutemesenteric ischaemia according to disease aetiology. Br J Surg. 2004;91:17-27.
8
Merle C, Lepouse C, de Garine A, et al. Surgery for mesenteric infarction: prognostic factors associated with early death within 72 hours. J Cardiothorac Vasc Anesth. 2004;18:734-741.
9
Park WM, Gloviczki P, Cherry Jr K.J, et al. Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg. 2002;35:445-452.
10
Chaudhuri N, James J, Sheikh A, et al. Intestinal ischaemia following cardiac surgery: a multivariate risk model. Eur J Cardiothorac Surg. 2006;29:971-977.
11
Garofalo M, Borioni R, Nardi P, et al. Early diagnosis of acute mesenteric ischemia after cardiopulmonary bypass. J Cardiovasc Surg (Torino). 2002;43:455-459.
12
Yasuhara H. Acute mesenteric ischemia: the challenge of gastroenterology. Surg Today. 2005;35:185-195.
13
Blauth CI, Cosgrove DM, Webb BW, et al. Atheroembolism from the ascending aorta. An emerging problem in cardiac surgery. J Thorac Cardiovasc Surg. 1992;103:1104-1111.
14
Cernilia J, Godbe DH, Ott R, et al. Splenic infarction from cholesterol embolization following cardiopulmonary bypass. Cardiovasc Surg. 1995;3:607-610.
15
Woo K, Major K, Kohanzadeh S, et al. Laparotomy for visceral ischemia and gangrene. Am Surg. 2007;73:1006-1008.
16
Hamada T, Yamauchi M, Tanaka M, et al. Prospective evaluation of contrast-enhanced ultrasonography with advanced dynamic flow for the diagnosis of intestinal ischaemia. Br J Radiol. 2007;80:603-608.
17
Ofer A, Abadi S, Nitecki S, et al. Multidetector CT angiography in the evaluation of acute mesenteric ischemia. Eur Radiol. 2009;19:24-30.
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