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.