scholarly journals Gastrointestinal Complications Following Cardiac Surgery.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Alfred Ibrahimi ◽  
Saimir Kuçi ◽  
Ervin Bejko ◽  
Stavri Llazo ◽  
Jonela Burimi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Intestinal Ischemia ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Morbidity And Mortality ◽  
Gastrointestinal Complication ◽  
High Morbidity ◽  
Low Cardiac Output Syndrome ◽  
Gastrointestinal Complications

Purpose: gastrointestinal complication (GIC) following open heart surgery usually are rare but with high morbidity and mortality. The aim of this study was to see the outcome of these patients after complication, compared with a similar study found in literature. Identifying risk factors preoperatively and postoperatively in our patient’s series, for GIC.Materials and methods: Between January 2012 and December 2017 from 1990 operated cardiac patient 34 of them developed GIC, presenting gastro duodenal bleeding due to active ulcer, liver failure, pancreatitis, cholecystitis, or intestinal ischemia. We performed a retrospective analysis.Results: From all consecutive patient only 1.7 % developed GIC. Mortality rate was 55.8%, especially 100 % mortality in intestinal ischemia patient. Regarding risk factors, those were the same found in other similar study (age, atherosclerosis disease, by pass time, postoperative ARF, Low cardiac output syndrome.)Conclusion: GIC after cardiac surgery are rare but when it happens the mortality is very high not even of late diagnosis. In ages patients, diabetes, long by pass time, long hypoperfusion state. It is recommended to be alert for GIC for detection in early phase, and for reducing as much as possible morbidity and mortality.

Acute renal failure following open heart surgery: risk factors and prognosis

Perfusion ◽  
2005 ◽  
Vol 20 (6) ◽  
pp. 317-322 ◽  
Author(s):  
Ilknur Bahar ◽  
Ahmet Akgul ◽  
Mehmet Ali Ozatik ◽  
Kerem M Vural ◽  
Ali E Demirbag ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
High Morbidity ◽  
Open Heart ◽  
Preoperative Serum

Background: Acute renal failure (ARF) development after cardiac surgery carries high mortality and morbidity. Methods: Out of 14 437 consecutive patients undergoing open-heart surgery between January 1991 and May 2001, 168 (1.16%) developed postoperative ARF mandating hemodialysis. Possible perioperative risk factors, and the prognosis of this dreadful, often fatal complication were investigated. Results: The mortality rate in this group was 79.7% (134 patients). The risk factors associated with postoperative ARF were advanced age (p-0.000), diabetes mellitus (p-0.000), hypertension (p-0.000), high preoperative serum creatinine levels (p-0.004), impaired left ventricular function (p-0.002), urgent operation (p-0.000) or reoperation (p-0.007), prolonged cardiopulmonary bypass (CPB) (p-0.000) and aortic cross-clamp (ACC) (p-0.000) periods, level of hypothermia (p-0.000), concomitant procedures (p-0.000), low cardiac output state (p-0.000), re-exploration for bleeding or pericardial tamponade (p-0.000), and deep sternal or systemic infection (p-0.000). Of those who could be discharged from hospital, renal functions were restored in 21 patients (12.5%); however, eight patients (4.7%) became hemodialysis dependent. The mean follow-up period was 5.79/3.2 years (range: 4 months to 13 years; a total of 195 patient-years), and 10-year survival was 58.69/10.2% in the discharged patients. Conclusions: ARF development after cardiac surgery often results in high morbidity and mortality. Recognizing risk factors permits the timely institution of proper treatment, which is the key to reducing untoward outcomes.

scholarly journals Case report: Diagnosis and emergency surgery on a young patient with extensive aortic dissection without any risk factors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoud Shafiee ◽  
Mohsen Shafiee ◽  
Noorollah Tahery ◽  
Omid Azadbakht ◽  
Zeinab Nassari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Rare Condition ◽  
Underlying Disease ◽  
Case Presentation ◽  
History Of

Abstract Background Type A aortic dissection is a very dangerous, fatal, and emergency condition for surgery. Acute aortic dissection is a rare condition, such that many patients will not survive without reconstructive surgery. Case presentation We present a case 24-year-old male who came with symptoms of shortness of breath and cough. The patient underwent ECG, chest radiology, and ultrasound, where the patient was found to have right pleural effusion while his ECG was normal. In the history taken from the patient, he had no underlying disease, no history of heart diseases in his family. For a better diagnosis, ETT and aortic CT angiography was performed on the patient which confirmed the evidence of dissection. Immediately after the diagnosis, necessary arrangements were made for open heart surgery and the patient was prepared for surgery. The patient was admitted in the cardiac surgery ICU for 5 days and his medication was carefully administered. After the conditions were stabilized, the patient was transferred to the post-cardiac surgery ICU ward. The patient was discharged from the hospital one week after the surgery and returned to the office as an OPD one week after his discharge. Conclusion Various risk factors can play a role in creating aortic dissection. Therefore, it is necessary to pay attention to patients’ history for achieving a quick and definitive diagnosis. Therefore, to control the complications of placing the cannula as well as the duration of the surgery, it is very important to reduce the duration of pumping on the patient and to be very careful during the cannula placement.

scholarly journals A.14 Low cardiac output syndrome after open-heart surgery: intraoperative risk factors

1996 ◽  
Vol 76 ◽  
pp. 4-5
Author(s):  
S. Garrido ◽  
M.J. Martín ◽  
S. Rodiño ◽  
J. Llorens ◽  
C.R. Valdés ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Output ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output

scholarly journals Evaluation of Complications of Heart Surgery in Children With Congenital Heart Disease at Dena Hospital of Shiraz

2015 ◽  
Vol 8 (5) ◽  
pp. 33 ◽  
Author(s):  
Maryam Mirzaei ◽  
Samaneh Mirzaei ◽  
Elham Sepahvand ◽  
Afifeh Rahmanian Koshkaki ◽  
Marzieh Kargar Jahromi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Vascular Complications ◽  
Congenital Heart Surgery ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Cross Sectional

<p><strong>INTRODUCTION:</strong> Today, with progress in the field of congenital heart surgery, different complicated actions are done in children. These actions may be associated with several complications, especially open heart surgery in which the cardiopulmonary bypass (CPB) is used. Serious complications can be caused high morbidity and mortality rates. Present study has been performed to determine the incidence of morbidity and mortality in cardiac surgery in children.</p> <p><strong>METHOD:</strong> In a cross-sectional retrospective, records of 203 patients undergoing surgery for congenital heart disease in Dena hospital during 2013-2015 were reviewed for incidence of complications. Data was analyzed by using descriptive and analytical statistics and using SPSS version 18.</p> <p><strong>RESULTS:</strong> The mean age of samples was 3/65±4/47 years. The majority of samples (73/8%) were undergoing open surgery. The overall adverse cardiovascular complications were respectively, renal complications (44/3%), lung (40/3%), anemia (35/9%), heart (34/4%), gastrointestinal (17/2%), brain (14/2%), need for re-intubation of the trachea 11/3%), infection (7/8%) required reoperation (5/9%) and vascular complications (1/4%).</p> <p><strong>CONCLUSION:</strong> High incidence of complications after congenital heart surgery makes necessary attention to complications and their treatment after surgery. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.</p>

Gastrointestinal complications following cardiac surgery

2020 ◽  
Vol 28 (9) ◽  
pp. 621-632
Author(s):  
Cheryl Yan Ting Chor ◽  
Saira Mahmood ◽  
Inayat Hussain Khan ◽  
Manasi Shirke ◽  
Amer Harky
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Preventive Measures ◽  
Signs And Symptoms ◽  
Mortality Rates ◽  
Gastrointestinal Complication ◽  
Gastrointestinal Complications ◽  
Ischemic Bowel ◽  
Preventative Measures ◽  
Life Threatening

Gastrointestinal complications after cardiac surgery may be uncommon but they carry high mortality rates. Incidences range from 0.5% to 5.5%, while mortality rates of such complications vary from 0.3% to 87%. They range from small gastrointestinal bleeds, ileus, and pancreatitis to life-threatening complications such as liver failure and ischemic bowel. Due to the vague and often absence of specific signs and symptoms, diagnosis of a gastrointestinal complication is often late. This article aims to review and summarize the literature concerning gastrointestinal complications after cardiac surgery. We discuss the causes, risk factors, diagnosis, preventative measures, and management of these complications. In general, risk factor identification, preventive measures, early diagnosis, and swift management are the keys to reducing the occurrence of gastrointestinal complications and their associated morbidity and mortality.

scholarly journals Comparative assessment of the frequency and risk factors of purulent-septic infections in adult patients after various types of open and closed heart surgery

2020 ◽  
Vol 25 (2) ◽  
pp. 78-87
Author(s):  
Victor I. Sergevnin ◽  
Larisa G. Kudryavtseva
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Incidence Rates ◽  
Comparative Assessment ◽  
Open Heart ◽  
Patient Stay ◽  
Subsequent Patient

BACKGROUND: The widespread increase in the number and types of cardiac surgery necessitate the study of frequency and risk factors of postoperative purulent-septic infections (PSIs). AIM: to provide a comparative assessment of the PSI frequency and risk factors in adult patients after various types of cardiac surgery. MATERIALS AND METHODS: Based on the cardiac surgery hospital materials, medical records of 4.815 patients over 18 years of age, who underwent open (n = 1.540) and closed (n = 3.275) heart surgeries within 1 year, were analyzed. The typical and prenosological forms of PSIs were taken into account in accordance with the epidemiological standard of case definition. RESULTS: The incidence rates for typical and prenosological PSI forms amounted to 39.6 and 72.7 per 1000 surgeries after open heart surgery, respectively, and 3.1 and 3.9 after minimally invasive endovascular surgical interventions, respectively. The main clinical forms of PSI after open and closed heart surgeries were surgical site infections, nosocomial pneumonia, urinary tract infection, and bloodstream infection. In an open heart surgery, the maximum incidence rates for typical and prenosological forms of PSIs were recorded after surgeries on the aorta and less often after heart valve replacement or coronary artery bypass grafting. The increased incidence rate after aortic surgery was mainly due to urinary tract infection and nosocomial pneumonia. In the case of closed heart surgery, no statistically significant differences were detected between the incidence rates of PSIs after coronary artery stenting, cardiac arrhythmia and carotid artery stenosis surgery, and other interventions. The duration of both the surgery itself and the subsequent patient stay in the intensive care unit was found to be important as risk factors for PSIs after cardiac surgery. CONCLUSION: The incidence rate of PSIs after open heart surgery is significantly higher than after closed heart surgery, which is mostly associated with the duration of surgical intervention and the subsequent patient stay in the intensive care unit.

scholarly journals Invasive Mycobacterium abscessus Infection after Cardiac Surgery: Epidemiology and Clinical Outcomes

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S35-S36
Author(s):  
Arthur W Baker ◽  
Eileen K Maziarz ◽  
Sarah S Lewis ◽  
Jason E Stout ◽  
Deverick J Anderson ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Antimicrobial Therapy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Mycobacterium Abscessus ◽  
Surgical Debridement ◽  
Ventricular Assist Devices ◽  
High Morbidity ◽  
Invasive Infection

Abstract Background We recently mitigated a clonal outbreak of Mycobacterium abscessus, including a large cluster of patients who developed invasive infection after exposure to heater-cooler units (HCU) during cardiac surgery. Recent studies have described a small number of Mycobacterium chimera infections linked to open-heart surgery; however, little is known about the epidemiology and clinical courses of cardiac surgery patients with invasive infection from rapidly-growing mycobacteria, such as M. abscessus. Methods We retrospectively collected clinical data from all patients who underwent cardiac surgery at our hospital and had positive cultures for M. abscessus from 2013 to 2016. We excluded heart transplant recipients and patients who at time of diagnosis had ventricular assist devices. We analyzed patient characteristics, antibiotic treatment courses, surgical interventions, and clinical outcomes. Results Nine cardiac surgery patients who met the case definition developed culture-proven invasive infection from M. abscessus (Figure 1). Seven (78%) infections occurred after surgeries that included valve replacement. Median time from suspected inoculation in the operating room to first positive culture was 49 days (interquartile range, 38–115 days). Seven (78%) patients had bloodstream infections, and six (67%) patients had sternal wound infections. Six (67%) patients developed disseminated disease with infection at multiple sites. All patients received combination antimicrobial therapy. The most common majority regimen (n = 6) was imipenem, amikacin, and tigecycline. Four (44%) patients experienced therapy-limiting antibiotic toxicities (Figure 2). Seven (78%) patients were well enough to undergo at least one surgical debridement. Five (56%) patients stopped therapy due to presumed cure, but four (44%) patients had deaths attributable to M. abscessus infection. Conclusion Invasive M. abscessus infection after cardiac surgery was associated with high morbidity and mortality. Most patients underwent surgical debridement and received prolonged three-drug antimicrobial therapy, which was complicated by numerous antibiotic toxicities. Treatment cured five patients, but four patients died from mycobacterial disease. Disclosures All authors: No reported disclosures.

scholarly journals Coronary Sinus Lactate as Marker of Myocardial Ischemia in Cardiac Surgery: Correlation with Morbidity and Mortality after Cardiac Surgery / Lactatul din sinusul coronarian - marker al ischemiei miocardice în chirurgia cardiacă: corelaţii cu morbiditatea şi mortalitatea postoperatorie

2015 ◽  
Vol 23 (2) ◽  
Author(s):  
Victor Raicea ◽  
Judit Kovacs ◽  
Liviu Moraru ◽  
Horatiu Suciu
Keyword(s):  
Cardiac Surgery ◽  
Coronary Sinus ◽  
Lactate Level ◽  
Heart Surgery ◽  
Contractile Function ◽  
Open Heart Surgery ◽  
Morbidity And Mortality ◽  
Rapid Decline ◽  
Open Heart ◽  
Lactate Levels

AbstractIntroduction. Perioperative myocardial injuries are one of the most frequent causes of morbidity and mortality after cardiac surgery, the most common etiology being the poor myocardial protection during aortic crossclamp. During aortic crossclamp progressive accumulation of lactate and intracellular acidosis are well-known phenomena, and are associated with alteration of myocardial contractile function. Our objective was to study the coronary sinus lactate levels as a predictor of postoperative hemodynamic outcome in open-heart surgical patients.Material and methods. We performed a prospective clinical trial, including 142 adult patients with elective cardiac surgery. Anterograde cardioplegia was administered in 82 patients, retrograde cardioplegia in 60 (in 30 patients it was administrated intermittently and in 30 continuously). Blood was collected simultaneously from the aortic cardioplegic line (inflow) and from coronary sinus or the aortic root (outflow) before aortic crossclamp, after crossclamp at every 10 minutes and after crossclamp removal at 0 and 10 minutes. All patients were operated on cardiopulmonary bypass with cardiac arrest, using warm-blood cardioplegia for cardioprotection.Results. Lactate levels showed increasing values during aortic crossclamp, and a rapid decline after crossclamp removal. The incidence of low cardiac output was significantly higher in patients with lactate levels that exceeded 4 mmol/L. In patients who died in the postoperative period, lactate level was even higher (5 mmol/L), with only a modest recovery after crossclamp removal.Conclusion. Monitoring lactate level in coronary sinus blood is a reliable method and has a good prognostic value regarding postoperative morbidity and mortality in open heart surgery

scholarly journals Colonic diverticulitis following open-heart surgery: a case report of an unusual postoperative gastrointestinal complication

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Derrick Acheampong ◽  
Percy Boateng
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Gastrointestinal Disease ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Perforated Diverticulitis ◽  
Left Ventricular Aneurysm ◽  
Gastrointestinal Complication ◽  
Open Heart

Abstract Diverticulitis, though a common gastrointestinal disease, is rare following open-heart surgery. There is insufficient data regarding its incidence and management post-cardiac surgery. Especially in patients with atypical presentation, diagnosis and management can be challenging. This case outlines one such atypical diverticulitis case in which a 57-year-old female patient developed perforated diverticulitis with pelvic abscess accumulation following left ventricular aneurysm (LVA) repair. Diagnosis, appropriate management and treatment approaches are discussed. Cardiac surgeons should consider the possibility of diverticulitis in patients reporting nonspecific abdominal pain following cardiac surgery to ensure early diagnosis and institution of appropriate treatment to prevent associated adverse outcomes.

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