Early reopening performed for the management of complications in patients undergoing cardio-thoracic surgical procedures

DR.K.DHAMODARAN; DR.R.SANJEEV PANDIAN; DR.D.SATHISH KUMAR

Volume : VIII, Issue : I, January - 2019

Early reopening performed for the management of complications in patients undergoing cardio-thoracic surgical procedures

Dr. K. Dhamodaran, Dr. R. Sanjeev Pandian, Dr. D. Sathish Kumar

Abstract :

Objective: To detect the rate and predisposing factors for the development of postoperative complications requiring re-opening for their control in the immediate postoperative period. Methods: During the time period 2014-2018, 453 patients who underwent a wide range of cardio thoracic surgery procedures, were retrospectively collected. Data of patients who underwent early re-operation for the management of postoperative complications were assessed for identification of the responsible causative factors. Results: Overall,20/453 patients (4.4%) underwent early re-operation to control postoperative complications. Early re-operation was obviated by the need to control bleeding or to drain clotted hemothoraces in 17 cases (85%), to manage a onchopleural fistula in 1 case (5%), to manage wound dehiscence in 2 cases (10%). The factors responsible for the development of mediastinal bleeding were multifactorial(Recent antiplatelet drug administration,usage of Heparin,Cardio pulmonary bypass,Diseased myocardium,technical) in 17 cases (85%), onchopleural fistula were(Pneumonectomy,lung infections,mediastinal lymph node resection,technical) in 1case (5%) and wound dehiscence(Prior lung infections,wound infection) in 2cases (10%). Conclusions: The rate of complications requiring reoperation after cardio thoracic surgery procedures is low and it is mainly related to the recent administration of antiplatelet drugs,heparin usage,Cardio pulmonary bypass,diseased myocardium,technical issues from the initial surgery,pneumonectomy and surgery for infectious diseases