Introduction
Post-operative hemorrhage requiring re-exploration after cardiac surgery, still remained a troublesome complication. There are reports from the various authors about the adverse outcome associated with the re-exploration (1-6) while on the other hand, Tambe et al. believe that it is not associated with an adverse outcome (7). Nowadays due to advancement in cardiopulmonary bypass (CPB) technology and availability of point of care testing, the safety of cardiac surgery, in terms of bleeding, has been increased. However, many patients’ related, intraoperative as well as post-operative unmodifiable factors are still persists which can contribute to the bleeding. Because of all these issues, risk of bleeding could not be eliminated completely till date (1- 4).
There are many concerns associated with the re-exploration. It has been found to be an independent factor for mortality as well as major morbidity (1,5,6,8). Some authors also evaluated effect of timing of re-exploration on the adverse outcome; some authors reported better outcome with early re-exploration while others demonstrated no benefit from early re-exploration (6, 8-11). Re-exploration after coronary artery bypass surgery (CABG), which still remain the standard treatment for most patients with left coronary artery disease and multivessel disease, is also associated with higher mortality and morbidity (9,10). Now a days, the off-pump CABG (OPCABG) strategy has been tried to demonstrate with a lower rate of adverse effects, such as neurological complications by avoiding aortic manipulation and bleeding complications by avoiding complete heparinization and the inflammatory reactions resulting from cardiopulmonary bypass (12-14). Also there is still lack of data about the factors associated with re-exploration and mortality in the patients undergoing off pump coronary arterial bypass surgery (OPCABG). We here represent our Centre’s experience regarding risk factors of the mortality and morbidity in patients underwent re-exploration following OPCABG.