Prevention of gastroduodenal complications in coronary surgery. Usefulness of preoperative fiberoscopy

Fiberoscopic examination of the oesophagus, stomach and duodenum was carried out in 60 coronary disease patients prior to aorto-coronary bypass. Lesions of the upper digestive tract were detected in one-third of the patients; half of them were asymptomatic. The management of these cases depended upon the urgency of the cardiovascular operation. In 17 cases, a 1-month treatment of the digestive lesions with antacids and cimetidine was instituted immediately after fiberoscopy, and revascularization was performed 8 days later. In 3 cases, the cardiovascular operation was postponed; after 1 month of treatment only one patient had active lesions on control fiberoscopy and had to undergo digestive surgery prior to aorto-coronary bypass. No gastroduodenal complications of cardiovascular surgery was observed in this series.