Incidence and Risk Factors for Re-exploration Following Off Pump Coronary Artery Bypass Grafting

Re-exploration post to the cardiac surgery is a troublesome complication.There is an enigma of rare reported data about the effect of re-exploration after off-pump coronary artery bypass grafting (OPCABG).We here represent our institutional experience on re-exploration following OPCABG with follow up of 5 years.In the present study total of 1852 OPCABG were performed at tertiary multi-super specialty care center.Out of these patients, 22 (1.18%) were re-explored in the operation room and were included in this study.The medical records of these patients were retrospectively reviewed.The results showed that the most common cause of re-exploration was bleeding and the most common site of bleeding was general ooze.The mean time to re-exploration was 10.6 ± 5.76 (Hours, mean ± SD), and the Hospital Mortality of 2/22 cases was observed with 5 year follow up mortality of 7/22 cases.The observations, add the preliminary data in the literature for overall incidence (1.18%) of re-exploration with most common site of the bleeding that was generalized ooze (n = 12).Summarizing the delaying re-exploration increases the three-fold risk in mortality and morbidity.This study suggests that a strategy of reducing the incidence of re-exploration, like the use of minimally invasive surgery and early re-exploration with the judicial use of products, maintaining Operation theatre temperature should be used to improve outcomes after re-exploration following OPCABG.The need for re-exploration is surely not totally alleviated by using off pump coronary artery revascularization strategies.As there is lake of data reported in literature with the rate of incidence, effect of timing and associated risk factors of re-exploration after OPCABG.Minimally invasive surgery can be suggested as option to improve outcome after re-exploration for off pump CABG.Since, Re-exploration after off pump CABG is not associated with high mortality as per our study in contrast to other data reported in literature.Delaying the re-exploration is associated with increased drain out.The recommendable stanchion of minimizing the incidence of re-exploration after OPCAB should be judicial hemostasis during primary surgery and adequate core temperature management.Minimally invasive surgery is suggested choice to improve outcome after reexploration for off pump CABG.