Upper gastrointestinal bleeding after open heart surgery

Abstract

Objective: The occurrence of digestive complications especially upper gastrointestinal bleeding (UGIB) has increased after cardiac surgery. The aim of this study was to determine the incidence of UGIB and identify the independent risk factors. Materials and Methods: We retrospectively analyzed data of 1077 patients undergoing cardiopulmonary bypass (CPB) from 1994 to 2012 The group of patients with UGIB (n 1 = 20) was compared with the population group (n 2 = 1057). Demographic characteristics, therapeutic management, endoscopic findings, and outcomes were analyzed. Through a regression analysis we identified independent risk factors of UGIB. Results: The mean age of the group n 1 was 58.2 ± 12.4 years and 50.18 ± 13.5 years in the group n 2. UGIB occurred about 13 ± 5.5 days after cardiac surgery. Gastroduodenal ulcer was the most common etiology of hemorrhage (n = 13, 65%). Renal insufficiency, previous gastric ulcer, increased lactate concentration during CPB, prolonged mechanical ventilation, use of vasopressor drug and pulmonary infection was likely contributing factors in UGIB. Conclusion: UGIB following open cardiac surgery is most frequently secondary to gastroduodenal ulceration. Many determinant factors of bleeding are incriminated. Surgeons must be aware of these factors to avoid fatal complications.

Keywords

• gastrointestinal bleeding
• open cardiac surgery
• postoperative complications
• stress ulceration