Gastrointestinal haemorrhage after off-pump coronary artery bypass

Gastrointestinal haemorrhage secondary to off-pump coronary artery bypass grafting (OPCABG) surgery is uncommon but lethal. We describe an 83-year-old male patient who developed gastrointestinal haemorrhage after successful off-pump CABG. He received intensive treatment, but further deteriorated following noradrenaline infusion, and subsequently died six days after surgery. Off-pump technique in combination with an extensive calcified arterial system could lead to mesenteric ischaemia accounting for the postoperative gastrointestinal haemorrhage, which might be exacerbated by the use of noradrenaline in this octogenarian patient.