Gastrointestinal complications after cardiopulmonary bypass: sixteen years of experience.

BACKGROUND: Gastrointestinal (GI) complications are one of the serious complications of cardiac surgery. Although rarely seen, they cause major morbidity and mortality. The aim of the present study was to retrospectively analyze the risk factors acting on the GI complications seen after cardiac operations performed under cardiopulmonary bypass. METHOD: The present study was designed to retrospectively evaluate 13,544 patients who underwent cardiac surgery under cardiopulmonary bypass, between 1988 and 2004 in the authors' clinic. RESULTS: The overall mortality was 346 (2.55%) of 13,544 patients. GI complications developed in 128 patients (0.94%). Among those, 18 (14.1%) died because of GI complications, the most common of which was bleeding. Mesenteric ischemia had the highest case-fatality rate at 71.4%. Valve surgery, concomitant valve and coronary artery bypass grafting surgery, preoperative chronic renal dysfunction, postoperative acute renal failure, deep sternal infection, prolonged ventilation, need for intra-aortic balloon pump and ejection fraction less than 30% were found to be risk factors acting on GI complications. CONCLUSION: GI complications remain a significant concern after cardiac surgery under cardiopulmonary bypass. Higher-risk patients can be identified and treated prophylactically and in the postoperative period.