Acute Mesenteric Ischemia and Splenic Infarct After Coronary Bypass Surgery: An Analysis of 32 Patients
Journal Title: Journal of Ankara University Faculty of Medicine - Year 2019, Vol 72, Issue 2
Abstract
Objectives: Acute mesenteric ischemia and other end organ emboli are serious life-threatening complications after open-heart surgery. In this study, we evaluated the outcome of patients with mesenteric ischemia and splenic infarction after cardiac surgery. Materials and Methods: From January 2010 to November 2017, all patients (5607) who underwent open-heart surgery were analysed, and patients with registered acute mesenteric ischemia and splenic infarct (32) were retrospectively reviewed. Results: Five thousand six hundred and seven patients were included in this study, of which 32 (0.57%) patients suffered from acute mesenteric ischemia and splenic infarct. Intraoperatively, splenic infarction was detected in six patients who were pre-diagnosed as mesenteric ischemia. In these patients, the symptoms completely improved after the splenectomy and all the patients survived. Only two of 26 patients were survived after segmentary bowel resection. Overall mortality was 24 (%75). Age (p=0.03), need for dialysis (p=0.01), emergency cardiac operation (p=0.05), peripheral arterial disease (p=0.001), and high risk Euroscore (p=0.0001) were significantly different compared to the control group. Mesenteric ischemia was significantly higher in off- pump coronary artery bypass patients (p=0.0001). The time of cardiopulmonary bypass in mesenteric ischemia group was significantly higher than the control group (p=0.0001). Conclusion: Acute mesenteric ischemia is still highly mortal, after cardiac surgery. Splenic infarct symptoms may mimic mesenteric ischemia. Mesenteric ischemia is more common in high-risk cardiac operations. Prompt diagnosis and treatment can be life-saving.
Authors and Affiliations
Çağdaş Baran1, Mehmet Çakıcı1, Evren Özçınar1, Ali İhsan Hasde1, Ömer Arda Çetinkaya2, Serkan Durdu1, Mustafa Bahadır İnan1, Mustafa Şırlak1, Ahmet Rüçhan Akar
Keywords
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