Hindawi Publishing Corporation he Scientiic World Journal Volume 2013, Article ID 631534, 8 pages http://dx.doi.org/10.1155/2013/631534 Clinical Study Acute Mesenteric Ischemia after Cardiac Surgery: An Analysis of 52 Patients Cuneyt Eris, 1 Senol Yavuz, 1 Serhat Yalcinkaya, 2 Arif Gucu, 1 Faruk Toktas, 1 Gunduz Yumun, 1 Burak Erdolu, 1 and Ahmet OzyazJcJoglu 1 1 Departments of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey 2 Departments of oracic Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey Correspondence should be addressed to Cuneyt Eris; dr ceris@hotmail.com Received 13 August 2013; Accepted 8 September 2013 Academic Editors: R. M. Mentzer and H. Nakagami Copyright © 2013 Cuneyt Eris et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. Acute mesenteric ischemia (AMI) is a rare but serious complication ater cardiac surgery. he aim of this retrospective study was to evaluate the incidence, outcome, and perioperative risk factors of AMI in the patients undergoing elective cardiac surgery. Methods. From January 2005 to May 2013, all patients who underwent cardiac surgery were screened for participation, and patients with registered gastrointestinal complications were retrospectively reviewed. Univariate analyses were performed. Results. he study included 6013 patients, of which 52 (0.86%) patients sufered from AMI, 35 (67%) of whom died. he control group (150 patients) was randomly chosen from among cases undergoing cardiopulmonary bypass (CPB). Preoperative parameters including age ( = 0.03), renal insuiciency ( = 0.004), peripheral vascular disease ( = 0.04), preoperative inotropic support ( < 0.001), poor let ventricular ejection fraction ( = 0.002), cardiogenic shock ( = 0.003), and preoperative intra-aortic balloon pump (IABP) support ( = 0.05) revealed signiicantly higher levels in the AMI group. Among intra- and postoperative parameters, CPB time ( < 0.001), dialysis ( = 0.04), inotropic support ( = 0.007), prolonged ventilator time ( < 0.001), and IABP support ( = 0.007) appeared signiicantly higher in the AMI group than the control group. Conclusions. Prompt diagnosis and early treatment should be initiated as early as possible in any patient suspected of AMI, leading to dramatic reduction in the mortality rate. 1. Introduction Abdominal complications ater CPB for cardiac surgery are seen with an incidence of 0.4–2.9%, and acute mesenteric ischemia (AMI) represents 10%–67% of these complications [1–4]. Although infrequent, it is one of the serious compli- cations of cardiac surgery characterized by extremely high mortality rates (40% to 94%). his is attributed to delayed diagnosis and inefective treatment choices [5–7]. here is a risk of delayed diagnosis and treatment because such patients are oten intubated and sedated, and, therefore, they are unable to alert the clinician about their symptoms and the intestinal ischemia may not become clinically evident until hours or days. here are four common causes of AMI: acute embolism to the superior mesenteric artery, acute thrombosis of an atherosclerotic plaque with previous partial occlusion, splanchnic vasoconstriction leading to low low and regional ischemia that is called nonocclusive mesenteric ischemia (NOMI), and mesenteric venous thrombosis [8]. Intestinal ischemia ater cardiac surgery mostoten is due to a NOMI, and it is related to a reduction in the splanchnic blood low, which can be due to low cardiac output, and it may also be aggravated by inotropic support, such as vasopressors, and by preexisting atherosclerosis [9, 10]. he ischemia due to arterial emboli, arterial thrombosis, or venous thromboembolism is less commonly seen ater CPB [11]. here are many demographic and surgical variables seen as risk factors for intestinal ischemia ater CPB, such as arterial hypotension, postoperative heart failure, renal insuiciency, age >70 years, hypovolemia, cardiopulmonary