ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
ANALYSIS OF SURGICAL REEXPLORATION FOR BLEEDING AS A RISK FACTOR FOLLOWING OPEN HEART SURGERY
Hakan GERÇEKOĞLU, Süheyla KESER, Serap ŞİMŞEK, Bige AYDIN, Serdar EVRENKAYA, Tufan ŞENER, Remzi TOSUN, Ergin EREN, Azmi ÖZLER
Prof. Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Merkezi, Enfeksiyon Hastalıkları Kliniği, İSTANBUL
Following open heart surgery , surgical reexploration for bleeding in the early postoperative period is an important risk factor of morbidity. 1622 patients who underwent open heart surgery between November 1998 and December 1999 were studied retrospectively. Among these , 28 patients who were reexplorized for bleeding in the early postoperative period were analyzed using multivariant stepwise logistic regression analyzes taking age, sex, operation, urgency, emergency, previous cardiac operation, bleeding time, use of anticoagulants, renal failure, diabetes mellitus, New York Heart Association class, cardiopulmonary bypass time, aortic cross clamp time, as covaryants these 28 patients are compared to the remaining group in respect to sternal wound infection, mediastinitis , adult respiratuar disstress syndrome, renal failure and stroke. Incidence of reexploration is 1.7%. Three factors were found to be as risk factors in early postoperative bleeding: these were advanced age (p<0.03), previous cardiac operation (p<0.003) and prolonged duration of cardiopulmonary bypass (p<0.04). Reexploration for bleeding is identified to be a risk factor for adverse outcomes like sternal wound infections (p<0.01) and mediastinitis (p<0.02). In conclusion, we have demonstrated that three risk factors-advanced age, previous cardiac operation and prolonged cardiopulmonary bypass time-increase the risk of postoperative bleeding and reexploration. As reexploration for bleeding affects the postoperative outcome, carefull hemostasis should be done to avoid reexploration.
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