Abdominal Complications following Open Heart Surgery: A Study of Outcome and Variables in 3039 Cases

Abstract

This study was designed in order to determine the incidence and clinical variables affecting abdominal complications after open-heart surgery. We included all consecutive patients from 1^st April 1997 to 31 March 1999 undergoing open-heart surgery in this study. Case notes of 76 patients who had abdominal complications were reviewed. Seventy-six patients (2.5%) had 80 abdominal complications, which included gastrointestinal bleeding (40%), hepatic failure (5 %), ¡leus (8.8%), acute abdomen (22.5%), pancreatitis (7.5%), ischemic bowel (8.8%), bowel perforation (5%) and acute acalculous cholecystitis (1.3%). Overall mortality for patients with abdominal complications was 32.9%. Mortality for Ischemic bowel, bowel perforation and hepatic failure was 87.5%, 75% and 50% respectively. Of thirteen patients who underwent laparotomy, 3 had negative laparotomy, 2 had extensive irresectible ischemic bowel while 8 patients underwent definitive surgical procedures. Higher mortality for bowel perforation was attributed to delayed diagnosis. Out of 30 patients who had GI bleed only 3 had previous history of acid peptic disease. Patients on aspirin and warfarin together had a higher incidence of CI bleeding (p0.05. We conclude that abdominal complications following open-heart surgery are not rare and carry a very high mortality. Ischemic bowel and delayed diagnosis of bowel perforation remain important causes of mortality.