Original articlesAlterations of mesenteric blood flow after cardiopulmonary bypass: A Doppler sonographic study
Section snippets
Material and methods
Thirty patients who underwent coronary artery bypass grafting were studied. This series consisted of 22 men and 8 women with a mean age of 63 ± 8 years. Preoperative left ventricular function was normal in all patients (ejection fraction 74% ± 11%). Preoperative and postoperative Duplex and color-flow Doppler evaluations of the superior mesenteric artery were performed 30 minutes after induction of anesthesia for preoperative values and 60 minutes after end of surgery for postoperative values,
Results
In 5 of 30 patients, sonographic investigation was not possible because of poor visualization of the superior mesenteric artery. In the remaining 25 patients, sufficient visualization of the superior mesenteric artery could be achieved to obtain proper Doppler signals.
The mean CPB and cross-clamp times were 94 ± 19 and 39 ± 14 minutes, respectively, and no significant differences could be found between preoperative and postoperative values of cardiac output (5.4 ± 0.8 v 5.1 ± 0.6 L/min),
Discussion
Gastrointestinal complications are rare after cardiac surgery, arising in 0.5% to 3.0% of patients, and the proportion of those suffering from mesenteric ischemia is reported to be 11% to 30%.1, 2 Gut ischemia is reported with an incidence of 0.07% to 0.60%.3, 4, 6, 7 In 1978, Aakhus and Evensen5 first showed the benefit of arteriography in diagnosing splanchnic ischemia. They further described a treatment option for mesenteric arterial spasm by the injection of tolazoline through the
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