Gastointestinal complications after open heart surgery

Aim : Gastrointestinal complications after open heart surgery are rare but have high morbidity and mortality. Types, diagnosis, treatment and follow up of the gastrointestinal complications vary. In this study, preterm gastrointestinal complications following open heart surgery prospectively analysed. Material and Method : Between April 2011 ? April 2012 200 patients who underwent open heart surgery in our clinic selected randomly and prospectively involved in this study. All patients? age, gender, ejection fraction (EF), preoperative diabetes, gastrointestinal system ( GIS ) disease, atrial fibrilation ( AF ), preoperative and postoperative use of statin, cardiopulmoner bypass (CPB) time, aortic cross clamping (ACC) time, postoperative blood transfusion amount, vasoactive drug dose and infusion time were recorded. The gastrointestinal enzymes alkaline phosphatase (ALP), lactat dehydrogenase (LDH), aspartate aminotranspherase (AST), alanine amino transpherase (ALT), gama glutamyl transferase (GGT), total bilirubin, direct bilirubin, amylase, lipase, lactat was monitored in preoperative, peroperative and daily for first week in postoperative. Findings : A total of 200 patients, 29% were female and 71% male, mean age was 60,39±12,25 . In 8 patients developed complications. Complications included cholecystitis in 5, Mirizzi?s Syndrome in 1 and cholelithiasis in 2 patients. Only dobutamine used group, statistically significant difference was observed in the patients who developed complications (p=0.035). Only one of these patients underwent surgery, other patients were treated and followed medicaly. A highly significant correlation was found between prolonged CPB and ACC times and increased levels of LDH and AST (p=0.0001). The average length of stay in surgical intensive care unit was 4 days, total length of stay in hospital was 12.87 ±5.48 days in patients who developed complications. Conclusions : In patients undergoing cardiac surgery, examination of symptoms and findings together with the enzymes levels and fast surgery technique under ideal conditions may considered as important factors for prevention and early diagnosis of gastrointestinal complications. Keywords : Heart surgery, gastrointestinal complications, cholecystitis, aortic clamp.