OBJECTIVES: Re-exploration after cardiac surgery remains a frequent complication with adverse outcomes. The aim of this study was to evaluate the impact of timing and indication of re-exploration on outcome. METHODS: A retrospective, observational study on a cohort of 209 patients, who underwent re-exploration after cardiac surgery between January 2005 and December 2011, was performed. The cohort was matched for age, gender, and procedure with patients who were not re-explored during the same period. RESULTS: The intraoperative and postoperative transfusion requirements were higher in the re-exploration group (p < 0.01). Patients in the re-exploration group had significantly higher incidences of postoperative acute renal injury (10.0 vs. 3.3%), sternal wound (9.1 vs. 2.4%) and pulmonary (13.4 vs. 4.3%) infections, longer ventilation time (22 [range, 14-52] vs. 12 [range, 9-16] hours) and intensive care unit stay (5 [range, 3-7] vs. 2 [range, 2-4] days), and higher mortality rate (9.6 vs. 3.3%). However, the multivariate logistic regression analysis demonstrated that not the re-exploration itself, but the deleterious effects of re-exploration (blood loss and transfusion requirement) were independent risk factors for mortality. Mortality was 5.3% for patients who were re-explored within the first 12 hours and 20.3% for patients who were re-explored after 12 hours (p = 0.003). Mortality was 3.6% for patients with bleeding and 31.4% for patients with cardiac tamponade for indication of re-exploration (p < 0.001). CONCLUSIONS: This study suggests that re-exploration after cardiac surgery is associated with increased mortality and morbidity. Patients with delayed re-exploration and suffering from cardiac tamponade have adverse outcome. Georg Thieme Verlag KG Stuttgart · New York.
OBJECTIVES: Re-exploration after cardiac surgery remains a frequent complication with adverse outcomes. The aim of this study was to evaluate the impact of timing and indication of re-exploration on outcome. METHODS: A retrospective, observational study on a cohort of 209 patients, who underwent re-exploration after cardiac surgery between January 2005 and December 2011, was performed. The cohort was matched for age, gender, and procedure with patients who were not re-explored during the same period. RESULTS: The intraoperative and postoperative transfusion requirements were higher in the re-exploration group (p < 0.01). Patients in the re-exploration group had significantly higher incidences of postoperative acute renal injury (10.0 vs. 3.3%), sternal wound (9.1 vs. 2.4%) and pulmonary (13.4 vs. 4.3%) infections, longer ventilation time (22 [range, 14-52] vs. 12 [range, 9-16] hours) and intensive care unit stay (5 [range, 3-7] vs. 2 [range, 2-4] days), and higher mortality rate (9.6 vs. 3.3%). However, the multivariate logistic regression analysis demonstrated that not the re-exploration itself, but the deleterious effects of re-exploration (blood loss and transfusion requirement) were independent risk factors for mortality. Mortality was 5.3% for patients who were re-explored within the first 12 hours and 20.3% for patients who were re-explored after 12 hours (p = 0.003). Mortality was 3.6% for patients with bleeding and 31.4% for patients with cardiac tamponade for indication of re-exploration (p < 0.001). CONCLUSIONS: This study suggests that re-exploration after cardiac surgery is associated with increased mortality and morbidity. Patients with delayed re-exploration and suffering from cardiac tamponade have adverse outcome. Georg Thieme Verlag KG Stuttgart · New York.
Authors: J Trent Magruder; Stephen Belmustakov; Rika Ohkuma; Sarah Collica; Joshua C Grimm; Todd Crawford; John V Conte; William A Baumgartner; Ashish S Shah; Glenn R Whitman Journal: Gen Thorac Cardiovasc Surg Date: 2016-09-20
Authors: Dennis F J Ellenbroek; Luc van Kessel; Wilma Compagner; Tim Brouwer; R Arthur Bouwman; Bart A H M van Straten; Luuk C Otterspoor; Ashley J R De Bie Journal: Eur J Cardiothorac Surg Date: 2022-06-15 Impact factor: 4.534
Authors: Gijs J van Steenbergen; Albert H M van Straten; Serhat Kabak; Dennis van Veghel; Lukas Dekker; Mohamed A Soliman-Hamad Journal: Interact Cardiovasc Thorac Surg Date: 2021-10-29
Authors: Johan S J Manshanden; Chantal L I Gielen; Corianne A J M de Borgie; Robert J M Klautz; Bas A J M de Mol; David R Koolbergen Journal: EBioMedicine Date: 2015-07-31 Impact factor: 8.143