Incidence and source of hyperamylasemia after cardiac surgery.

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Abstract
We investigated the incidence and possible mechanisms of postoperative hyperamylasemia in 101 patients after cardiac surgery. Amylase (EC 3.2.1.1) activities in serum were increased in 36% of patients after bypass surgery, 59% of patients after valve replacement, and in 69% of patients after combined bypass and valve replacement. Lipase (EC 3.1.1.3) activity was increased in 30% of all patients. We found enzymatic evidence for pancreatitis in six patients. Thirty-six patients showed increased salivary (S-type) amylase activity, with a positive correlation (r = 0.55, P less than 0.001) between the severity of pleural effusions and the peak S-type amylase activity. Hyperamylasemia after cardiac surgery is apparently often related to absorption of S-type amylase from pleural fluid and (or) from aspirated salivary secretions. Monitoring patients for postsurgical pancreatitis necessitates assay of amylase isoenzymes to distinguish abnormalities resulting in release of pancreatic (P-type) amylase from those involving release of S-type amylase.