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Gastro-intestinal complications after open heart surgery

Mahdi Aithoussa, Noureddine Atmani, Younes Moutakiallah, Abdessamad Abdou, Fouad Nya, MehdiBamous, Siham Bellouize, Youssef Motiaa, Youssef Elbekkali, Mohamed Drissi, Abdelatif Boulahya

Objectives: Gastrointestinal complications (CIG) are serious consequences after open heart cardiopulmonary bypass (CPB), and associated with high mortality rate. The aim of the present study was to identify the risk factor for this problem in order to optimize medical management before its occurrence.

Patients and methods: We retrospectively analyzed data of 2056 adult patients who underwent open heart surgery between 1994 and 2012. Among them 35 (1.7%) developed GIC in postoperative period. Preoperative, intra-operative and postoperative data were compared into two groups: with GIC (n=35) and those without GIC (n=2021).

Results:The overall mortality rate was higher in the GIC group (48.5% vs. 5.6%, p=0.0001). The most common GIC was upper gastrointestinal bleeding (57.1%), but the lethal GIC was mesenteric ischemia (100%). Univariate analysis identified many predictor factors of GIC but multivariate analysis revealed previous gastric ulcer (OR=7.4, CI=95%, p=0.001), postoperative renal insufficiency (OR=7.5, CI=95%, p=0.006) as significant risk factors for development of GIC.

Conclusion: Our multivariate logistic regression analysis found that risk factors of GIC were: previous gastric ulcer and postoperative renal insufficiency.