Læknablaðið - 15.09.2009, Page 25

FRÆÐIGREINAR
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Reoperation for bleeding following open heart surgery in lceiand
Introduction: Postoperative bleeding is a common and
potentially fatal complication following open heart surgery,
studies reporting a reoperation rate for bleeding in the
range of 2-6%. Surgical outcome after such reoperations
has not been previously studied in lceland.
Material and methods: In this retrospective study were
included all adults that underwent open heart surgery in
lceland during a 6 year period, between January 1,2000
and December 31,2005.
Results: There were 103 reoperations (mean age 68
years, 76% males), but throughout the same 6 year period
a total of 1295 open heart procedures were performed,
the reoperation-rate being 8%. One third of ail patients
were on aspirin and 8% on clopidogrel less than 5 days
before surgery. The bleeding in the primary operation
averaged 1523 ml (range 300-4780) and 3942 ml for the
first 24 hours postoperatively. Half of the patients were
reoperated on within 2 h and 97% within 24 hours. The
patients received on average 16.5 units of packed cells,
15.6 units of plasma and 2.3 sets of thrombocytes. The
most common postoperative complication was atrial
fibrillation (58.3%), pleural effusion that needed chest
tube drainage (24.3%), myocardial infarction (23.3%) and
sternal wound infection (11.7%). Median length of stay was
14 days (range 6-85), including 2 days (range 1-38) in ICU.
Operative mortality was 15.5% and 1 year crude survival
79.6%.
Conclusion: Reoperation-rate for bleeding was 8%, which
is higher compared to other studies. Bleeding is a serious
complication following open heart surgery with high
morbidity and significant mortality.
Smarason NV, Sigurjonsson H, Hreinsson K, Arnorsson T, Gudbjartsson T.
Reoperation for bleeding following open heart surgery in lceland. Icel Med J 2009; 95:567-573.
Key words: Postoperative bleeding, reoperation, open heart surgery, CABG, valve replacement, complications, transfusions, survival.
Correspondence: Tómas Guðbjartsson, tomasgud@iandspitaii.is
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Barst: 19. janúar 2009, - samþykkt til birtingar: 29. júní 2009
LÆKNAblaðið 2009/95 573
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