Attaullah Khan Niazi, Ammar Hameed Khan.
Complications after Reopening for Excess Bleeding in Coronary Artery Bypass Grafting (CABG).
Pak J Med Health Sci Jan ;12(1):21-6.

Background : Surgical re-opening due to postoperative bleeding still has a frequent incidence and is accompanied by various subsequent complications leading to an adverse postoperative course and increased mortality. Aim : To study the outcome of re-opening after CABG Design : Observational study. Setting: Department of Cardiac Surgery, Punjab Institute of Cardiology, Jail Road Lahore Duration with dates: January to December 2014. Sampling technique: Non probability convenient sampling . Methods: All re-opened cases for excessive bleeding that underwent CABG (elective / emergency) surgery were included in the study that fulfilled inclusion criteria . Results: The study population consisted of 76 patients fulfilling inclusion criteria. Age range was 36 to 72 yea rs with mean age of 58.75+/-7.8 6 years. Regarding complications, 42.1% (32) patients showed low cardiac output syndrome,, out of these 32 patientonly 9(35.5%) required intra Aortic Baloon Pump (IABP) in addition to inotropic support. only 6 (7.89%) patients developed postoperative arrhythmias. Thirty one (40.80%) patients developed respiratory complication and required mechanical ventilation more than 24 hours, 11 (14.5 %) had sternal wound infection while 8 out of 76 developed sepsis (10.5%) during postoperative period after re-opening. The incidence of stroke were found to be in 9 patient (11.84%). 6 (7.9 %) patients died and 70 (92.1 %) were discharged according to the schedule. There was male predominance, Out of 76, 61 (80%) patients underwent their CABG as an elective cardiac procedure and 15 (20%) patients as emergency procedure. 15 (20%). Conclusion: This study suggests that re-opening for bleeding post CABG carry a significant increase risk of postoperative mortality and morbidity.

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