PMID- 21475474
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20211020
IS  - 1658-3639 (Print)
IS  - 1658-3639 (Linking)
VI  - 2
IP  - 1
DP  - 2008 Jan
TI  - Prevalence and Outcome of Upper Gastrointestinal Bleeding Post-coronary Artery 
      Bypass Graft.
PG  - 69-76
AB  - BACKGROUND: Upper gastrointestinal bleeding (UGIB), a potentially fatal 
      occurrence, can sometimes follow coronary artery bypass graft (CABG) surgery. 
      However, little has been published about its prevalence, risk factors, and 
      outcomes. AIM: This study aimed to determine the rate, etiologies, predisposing 
      factors, and outcomes of UGIB following CABG. METHOD: The authors conducted a 
      retrospective chart review of all UGIBs which followed CABGs performed at the 
      University of Alberta Hospital from January 1, 1998 to December 31, 2002. 
      RESULTS: During the study period, 4,502 CABGs were performed at the UAH. Eighteen 
      patients (0.4%) had a documented major UGIB (defined as evidence of melena, red 
      or coffee-grounds emesis, blood per NG tube, or a decrease of Hgb by > 20 g/l and 
      requiring a confirmation by endoscopy or radiological study). Two of these 18 
      patients (11%) had a past history of peptic ulcer disease, and one of these 
      patients had had previous UGIB. Three patients (17%) had been taking proton pump 
      inhibitors (PPI) before the UGIB occurred. At the time of UGIB, PPIs were 
      prescribed for 16 patients (89%), and the PPIs achieved effective hemostasis as a 
      single agent for 10 (62.5%). Of the 18 patients, 16 (89%) underwent upper GI 
      endoscopy. Bleeding was found to be due to duodenal ulceration in 9 (56%), 
      esophagitis in 4 (22%) and gastritis in 6 cases (33%); fifty percent of these 
      patients had multiple sites of bleeding. Endoscopic therapeutic intervention was 
      needed by 6 patients (37.5%), and successful hemostasis was achieved for 5 of 
      these patients (83%). One patient had a recurrence of bleeding and required 
      surgery. One patient underwent surgery as the primary hemostatic therapy after a 
      diagnostic endoscopy. The overall surgical rate was 11.1% for this patient 
      cohort. In this cohort, three patients died, two from multi-organ failure, and 
      the third, a surgically managed patient, had a cardiac arrest 72 hours 
      post-surgery. The number of complication increased as both cardiopulmonary bypass 
      and cross clamp time increased. There were no endoscopy-related complications. 
      CONCLUSIONS: UGI bleeding following CABGs is relatively infrequent, occurring at 
      a rate of 0.4% in this study. Upper gastrointestinal bleeding post-CABG is most 
      frequently related to a duodenal ulcer, though 50% of the patients had multiple 
      bleeding sites. prolonged bypass and cross clamp time associated with more 
      complications.
FAU - Aljarallah, Badr
AU  - Aljarallah B
AD  - Departments of Medicine and.
FAU - Wong, Winnie
AU  - Wong W
FAU - Modry, Dennis
AU  - Modry D
FAU - Fedorak, Richard
AU  - Fedorak R
LA  - eng
PT  - Journal Article
PL  - Saudi Arabia
TA  - Int J Health Sci (Qassim)
JT  - International journal of health sciences
JID - 101528042
PMC - PMC3068711
OTO - NOTNLM
OT  - Coronary artery bypass surgery
OT  - Post-operative complications
OT  - Upper gastrointestinal bleeding
EDAT- 2008/01/01 00:00
MHDA- 2008/01/01 00:01
PMCR- 2008/01/01
CRDT- 2011/04/09 06:00
PHST- 2011/04/09 06:00 [entrez]
PHST- 2008/01/01 00:00 [pubmed]
PHST- 2008/01/01 00:01 [medline]
PHST- 2008/01/01 00:00 [pmc-release]
AID - ijhs-2-1-0069 [pii]
PST - ppublish
SO  - Int J Health Sci (Qassim). 2008 Jan;2(1):69-76.