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Effects of Preoperative Laboratory Findings to the Risk of Re-exploration after Coronary Artery Bypass Graft Surgery

Year 2019, Volume: 5 Issue: 2, 142 - 148, 01.04.2019

Betul Kocamer Simsek Feragat Uygur

https://doi.org/10.5455/umj.20190124064729

Abstract

Background: Coronary artery bypass grafting CABG operation is a surgical procedure commonly used in the treatment of patients with ischemic heart disease. In some cases, there is a need for re-exploration after CABG. This is a retrospective study conducted to determine the characteristics and risk factors of patients who underwent re-exploration because of bleeding after CABG operations in our center. Materials and Method: In the present study, patients who underwent coronary artery bypass grafting CABG operation with open heart surgery and required re-exploration in Sanko University, Medicine Faculty Hospital Cardiovascular Surgery Clinic between December 2016 and May 2018 were evaluated retrospectively. The demographic data, laboratory findings, lengths of stay in the ICU, and total lengths of stay in the hospital of all patients were recorded. The patients were divided into two groups as patients who underwent and those who did not undergo re-exploration. Results: A total of 200 patients, 131 65.5% males and 69 34.5% females, were included in this study. Of the patients, 13 6.5% had undergone the re-exploration operation because of bleeding after CABG. There was no statistically significant difference between the two groups in terms of age, gender, length of stay in the ICU and the total length of stay in the hospital. It was seen that 2 15.4% of the patients who underwent re-exploration were female and 11 84.6% were male. There was no significant difference between the patients in terms of preoperative period INR, APTT, BUN, creatinine, glucose, cholesterol levels, CBCT results and complete blood counts p>0.05 . Conclusion: It was determined that the clinical features and laboratory parameters of patients who underwent CABG operation were inadequate for being used to predict the re-exploration to be implemented because of bleeding in these patients. It is thought that prospective studies with more detailed data and larger patient participation are needed for this subject.

Keywords

Revision CABG Re-exploration Bleeding Sternotomy

References

  • 1. Reece TB, Cleveland JCJ. Noteworthy Literature in Cardiac Surgery in 2015. Semin Cardiothorac Vasc Anesth. 2016 Mar;20(1):34–9
  • 2. Kristensen KL, Rauer LJ, Mortensen PE, Kjeldsen BJ. Reoperation for bleeding in cardiac surgery. Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):709–13
  • 3. Biancari F, Mikkola R, Heikkinen J, Lahtinen J, Kettunen U, Juvonen T. Individual surgeon’s impact on the risk of reexploration for excessive bleeding after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2012 Aug;26(4):550–6
  • 4. Mehaffey JH, Hawkins RB, Byler M, Charles EJ, Fonner C, Kron I, et al. Cost of individual complications following coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2017
  • 5. Kubota H, Miyata H, Motomura N, Ono M, Takamoto S, Harii K, et al. Deep sternal wound infection after cardiac surgery. J Cardiothorac Surg. 2013 May;8:132
  • 6. Ruel M, Chan V, Boodhwani M, Mcdonald B, Ni X, Gill G, et al. How detrimental is reexploration for bleeding after cardiac surgery ? J Thorac Cardiovasc Surg [Internet]. 2015;154(3): 927–35
  • 7. Frojd V, Jeppsson A. Reexploration for Bleeding and Its Association With Mortality After Cardiac Surgery. Ann Thorac Surg. 2016 Jul;102(1):109–17
  • 8. Canádyová J. Re-exploration for bleeding or tamponade after cardiac operation. 2012;14(March):704–7
  • 9. Dacey LJ, Munoz JJ, Baribeau YR, Johnson ER, Lahey SJ, Leavitt BJ, et al. Reexploration for hemorrhage following coronary artery bypass grafting: incidence and risk factors. Northern New England Cardiovascular Disease Study Group. Arch Surg. 1998 Apr;133(4):442–7
  • 10. Unsworth-White MJ, Herriot A, Valencia O, Poloniecki J, Smith EE, Murday AJ, et al. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg. 1995 Mar;59(3):664–7
  • 11. Sellman M, Intonti MA, Ivert T. Reoperations for bleeding after coronary artery bypass procedures during 25 years. Eur J Cardiothorac Surg. 1997 Mar;11(3):521–7
  • 12. Ruel M, Chan V, Boodhwani M, McDonald B, Ni X, Gill G, et al. How detrimental is reexploration for bleeding after cardiac surgery? J Thorac Cardiovasc Surg. 2017 Sep;154(3):927–35
  • 13. Ranucci M, Bozzetti G, Ditta A, Cotza M, Carboni G, Ballotta A. Surgical Reexploration After Cardiac Operations: Why a Worse Outcome? Ann Thorac Surg. 2008;86(5):1557–62
  • 14. Ismail MF, El-Mahrouk AF, Hamouda TH, Radwan H, Haneef A, Jamjoom AA. Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience. J Cardiothorac Surg. 2017;12(1):40
  • 15. Karthik S, Grayson AD, McCarron EE, Pullan DM, Desmond MJ. Reexploration for bleeding after coronary artery bypass surgery: risk factors, outcomes, and the effect of time delay. Ann Thorac Surg. 2004 Aug;78(2):527–34
  • 16. Choong CK, Gerrard C, Goldsmith KA, Dunningham H, Vuylsteke A. Delayed re-exploration for bleeding after coronary artery bypass surgery results in adverse outcomes. Eur J Cardiothorac Surg. 2007 May;31(5):834–8
  • 17. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg. 1996 May;111(5):1037–46
  • 18. Lu JCY, Grayson AD, Jha P, Srinivasan AK, Fabri BM. Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2003 Jun;23(6):943–9

Year 2019, Volume: 5 Issue: 2, 142 - 148, 01.04.2019

Betul Kocamer Simsek Feragat Uygur

https://doi.org/10.5455/umj.20190124064729

Abstract

References

  • 1. Reece TB, Cleveland JCJ. Noteworthy Literature in Cardiac Surgery in 2015. Semin Cardiothorac Vasc Anesth. 2016 Mar;20(1):34–9
  • 2. Kristensen KL, Rauer LJ, Mortensen PE, Kjeldsen BJ. Reoperation for bleeding in cardiac surgery. Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):709–13
  • 3. Biancari F, Mikkola R, Heikkinen J, Lahtinen J, Kettunen U, Juvonen T. Individual surgeon’s impact on the risk of reexploration for excessive bleeding after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2012 Aug;26(4):550–6
  • 4. Mehaffey JH, Hawkins RB, Byler M, Charles EJ, Fonner C, Kron I, et al. Cost of individual complications following coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2017
  • 5. Kubota H, Miyata H, Motomura N, Ono M, Takamoto S, Harii K, et al. Deep sternal wound infection after cardiac surgery. J Cardiothorac Surg. 2013 May;8:132
  • 6. Ruel M, Chan V, Boodhwani M, Mcdonald B, Ni X, Gill G, et al. How detrimental is reexploration for bleeding after cardiac surgery ? J Thorac Cardiovasc Surg [Internet]. 2015;154(3): 927–35
  • 7. Frojd V, Jeppsson A. Reexploration for Bleeding and Its Association With Mortality After Cardiac Surgery. Ann Thorac Surg. 2016 Jul;102(1):109–17
  • 8. Canádyová J. Re-exploration for bleeding or tamponade after cardiac operation. 2012;14(March):704–7
  • 9. Dacey LJ, Munoz JJ, Baribeau YR, Johnson ER, Lahey SJ, Leavitt BJ, et al. Reexploration for hemorrhage following coronary artery bypass grafting: incidence and risk factors. Northern New England Cardiovascular Disease Study Group. Arch Surg. 1998 Apr;133(4):442–7
  • 10. Unsworth-White MJ, Herriot A, Valencia O, Poloniecki J, Smith EE, Murday AJ, et al. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg. 1995 Mar;59(3):664–7
  • 11. Sellman M, Intonti MA, Ivert T. Reoperations for bleeding after coronary artery bypass procedures during 25 years. Eur J Cardiothorac Surg. 1997 Mar;11(3):521–7
  • 12. Ruel M, Chan V, Boodhwani M, McDonald B, Ni X, Gill G, et al. How detrimental is reexploration for bleeding after cardiac surgery? J Thorac Cardiovasc Surg. 2017 Sep;154(3):927–35
  • 13. Ranucci M, Bozzetti G, Ditta A, Cotza M, Carboni G, Ballotta A. Surgical Reexploration After Cardiac Operations: Why a Worse Outcome? Ann Thorac Surg. 2008;86(5):1557–62
  • 14. Ismail MF, El-Mahrouk AF, Hamouda TH, Radwan H, Haneef A, Jamjoom AA. Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience. J Cardiothorac Surg. 2017;12(1):40
  • 15. Karthik S, Grayson AD, McCarron EE, Pullan DM, Desmond MJ. Reexploration for bleeding after coronary artery bypass surgery: risk factors, outcomes, and the effect of time delay. Ann Thorac Surg. 2004 Aug;78(2):527–34
  • 16. Choong CK, Gerrard C, Goldsmith KA, Dunningham H, Vuylsteke A. Delayed re-exploration for bleeding after coronary artery bypass surgery results in adverse outcomes. Eur J Cardiothorac Surg. 2007 May;31(5):834–8
  • 17. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg. 1996 May;111(5):1037–46
  • 18. Lu JCY, Grayson AD, Jha P, Srinivasan AK, Fabri BM. Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2003 Jun;23(6):943–9
There are 18 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Betul Kocamer Simsek

Feragat Uygur This is me

Publication Date April 1, 2019
Published in Issue Year 2019 Volume: 5 Issue: 2

Cite

Vancouver Simsek BK, Uygur F. Effects of Preoperative Laboratory Findings to the Risk of Re-exploration after Coronary Artery Bypass Graft Surgery. ULUTAS MED J. 2019;5(2):142-8.