Acute mesenteric ischemia after cardiopulmonary bypass Academic Article Article uri icon

Overview

MeSH Major

  • Aorta, Thoracic
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation
  • Endovascular Procedures
  • Postoperative Complications
  • Prosthesis Failure
  • Stents

abstract

  • Acute mesenteric ischemia is an uncommon but catastrophic event after cardiopulmonary bypass. From 1980 to 1990, 16,951 cardiac procedures requiring cardiopulmonary bypass were performed at Emory University Hospital in Atlanta, Ga. Eighteen patients (0.1%) had acute mesenteric ischemia that resulted in intestinal infarction. Emergency cardiac surgery had been performed in 16 of the 18 patients, and all 18 patients were vasopressor dependent for hemodynamic support after surgery. Diagnostic difficulties resulted in the diagnosis of intestinal infarction an average of 9 1/2 days after cardiopulmonary bypass. Nonocclusive mesenteric arterial ischemia was the determined cause in all cases. Statistically significant risk factors associated with acute mesenteric ischemia after cardiopulmonary bypass surgery included (1) emergency cardiac surgery (p less than 0.0001), (2) the use of an intraaortic balloon pump (p less than 0.0001), (3) failed angioplasty requiring emergency surgery (p = 0.0074), (4) prolonged pump time (p = 0.0093), and (5) advanced age (p = 0.0016). A high index of suspicion for mesenteric ischemia after cardiopulmonary bypass in patients with identified risk factors may decrease the diagnostic delay and lead to an improvement in the 67% mortality rate seen in this series.

publication date

  • January 1992

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1016/0741-5214(92)90372-F

PubMed ID

  • 1522641

Additional Document Info

start page

  • 391

end page

  • 5; discussion 395-6

volume

  • 16

number

  • 3