Summary
Acute gastrointestinal complications after cardiopulmonary bypass (CPB) are infrequent but serious and associated with high mortality. In attempt to determine the possible causative pre-, intra- and postoperative factors all patients who have undergone cardiac surgery involving the use of CPB during an 3-year period have been reviewed retrospectively. Of 6573 patients, 52 (0.79%) developed gastrointestinal complications within 15 days following cardiac surgery; the overall mortality was 52%. Postoperative atrial fibrillation, advanced age, prolonged pump time, valve and combined cardiac procedures, inotropic support, use of I.A.B.P., peripheral arterial disease, and nicotine abuse had an increased risk (p<0.001) for developing of gastrointestinal complications.
12 patients developed intraabdominal complications in association with postoperative atrial fibrillation; the mortality in this group was 75%. The findings in those patients (6 mesenterial ischemia or infarction and 3 ischemic colon perforation) are suggestive for an causative thromboembolic event. The postoperative conversion from sinus rhythmus in atrial fibrillation in association with abdominal problems results in an extremely high mortality, higher, than in patients with gastrointestinal complications only.
The combination of postoperative atrial fibrillation and abdominal symptoms is a life-threatening condition; an appropiate surgical treatment must be performed without delay.