Predictors of Gastrointestinal Perforation in Patients Undergoing Coronary Artery Bypass Graft (CABG) Surgery in Tehran, Iran

Nouredin Alebouyeh, MD, Mehrdad Toefigh, MD, Nima Ghasemzadeh, MD, Samineh Mirheydari, MD, and Ezonollah Azargashb, PhD

Background: Gastrointestinal perforation after coronary artery bypass graft (CABG) surgery is often difficult to diagnose and is associated with high morbidity and mortality rates. The aim of this study was to determine risk factors for this complication in the studied population to further improve prophylaxis and diagnosis in the region of study.
Methods: Of 8,975 consecutive patients undergoing CABG during 10 years (1995–2005), 15 (0.16%) developed gastrointestinal perforation requiring laparatomy. Data from patients who experienced gastrointestinal perforation were analyzed using univariate tests in a controlled retrospective design.
Results: Prolonged bypass time and preoperative heparin administration were found to be significant (P<0.05) risk factors.
Conclusion: Low splanchnic blood flow and vasoconstriction might be underlying factors associated with both predictors. With current findings, however, clear inference about preoperative and postoperative predictors and their relation is not possible. With more information, the next step would be to build a prediction model in recognition of gastrointestinal perforation after CABG on the basis of the predisposing factors. (Ann Thorac Cardiovasc Surg 2007; 13: 251-253)

Key words: coronary artery bypass graft, gastrointestinal complications, gastrointestinal perforation, Iran

School of Medicine, Shahid Beheshti University of Medical Sciences and Health Care, Tehran, Iran

Received October 20, 2006; accepted for publication October 26, 2006
Address reprint requests to Nouredin Alebouyeh, MD: Apt.808, 18 Hillcrest Ave., North York, ON, Canada.