Frequency of Reoperation due to Bleeding and Its Related Factors After Adult Cardiac Surgeries

Reoperation due to bleeding in adult cardiac surgeries is an important postoperative complication that increases mortality and morbidity. Studying the risk factors and outcomes of reoperation in these patients is imperative.

The present descriptive (cross-sectional) study performed a 3-month assessment of patients that underwent elective cardiac surgeries (coronary or valve surgeries or both). The inclusion criterion was being an adult undergoing elective cardiac surgeries on cardiopulmonary bypass (coronary or valve surgeries or both), and the exclusion criteria consisted of congenital heart diseases, cardiac surgeries without cardiopulmonary bypass, emergency cardiac surgeries, aneurysm and aortic dissection surgeries, known causes of bleeding due to acquired or congenital diseases, and redo cardiac surgeries.

Of 740 patients studied, 55 (7.43%) patients returned to the operating room due to bleeding. Of these 55 patients, 74.5% had bleeding due to surgical operations, 23.6% due to tamponade, and 1.8% due to coagulation disorders. Apropos risk factors, there was a significant relationship between the international normalized ratio (INR) and bleeding after cardiac surgeries leading to reoperation (P = 0.05).

In this study, 7.43% of the patients returned to the operating room because of bleeding, which is an acceptable percentage according to the literature. There was a significant relationship between preoperative INR and postoperative bleeding resulting in reoperation. (Iranian Heart Journal 2020; 21(4): 85-92)