Acute mesenteric ischemia after cardiopulmonary bypass

Keith B. Allen, Atef A. Salam, Alan B. Lumsden

Research output: Contribution to journalArticlepeer-review

81 Scopus citations

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 < 0.0001), (2) the use of an intraaortic balloon pump (p < 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.

Original languageEnglish (US)
Pages (from-to)391-396
Number of pages6
JournalJournal of Vascular Surgery
Volume16
Issue number3
DOIs
StatePublished - Sep 1992

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Acute mesenteric ischemia after cardiopulmonary bypass'. Together they form a unique fingerprint.

Cite this