ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2002 August;43(4):455-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Early diagnosis of acute mesenteric ischemia after cardiopulmonary bypass

Garofalo M., Borioni R., Nardi P., Turani F., Bertoldo F., Forlani S., Pellegrino A., Chiariello L.

Division of Cardiac Surgery “Tor Vergata” University of Rome, Rome, Italy

Background. The ­aim of ­this ­study is to iden­ti­fy sig­nif­i­cant ­risk fac­tors ­and even­tu­al clin­i­cal mark­ers asso­ciat­ed ­with ­acute mes­en­ter­ic ische­mia (­AMI) ­after car­di­o­pul­mo­nary ­bypass.
Methods. The ­study ­was ret­ro­spec­tive­ly per­formed on a ­group of 19 ­patients (­group A) under­go­ing car­diac sur­gery ­between January 1991 ­and December 1999, ­who devel­oped ­AMI with­in 30 ­days of ­their hos­pi­tal­iza­tion. A con­trol ­group of 48 ­patients (­group B) ­was com­pared in ­order to ­define pre­op­er­a­tive ­and oper­a­tive ­risk fac­tors ­for ­AMI.
Results. At ­the abdom­i­nal oper­a­tion, a ­non-occlu­sive mes­en­ter­ic ische­mia ­was ­found in eve­ry ­case. In-hos­pi­tal mor­tal­ity ­was 84.2% (16/19). Compared to ­the con­trol, ­there ­was a sig­nif­i­cant dif­fer­ence in aor­tic ­cross-­clamp ­time (p<0.001) ­and ­use of inotrop­ic ­drugs (p<0.01). Postoperatively, ­the stud­ied ­group (group A) ­had a sig­nif­i­cant­ly high­er ­mean val­ue of ­the enzy­mat­ic ser­um lev­els at ­any ­time.
Conclusions. A ­high ­index of sus­pi­cion ­for mes­en­ter­ic ische­mia ­after car­di­o­pul­mo­nary ­bypass ­should be con­sid­ered in ­patients ­with con­di­tions of hypo­per­fu­sion. The ear­ly labor­a­to­ry ­signs of ­AMI ­might be ­searched dur­ing ­the ­first post­op­er­a­tive ­hours.