ABSTRACT
INTRODUCTION: Chest re-exploration is potentially life-saving in the treatment of early post-operative complications of open-heart surgery such as for surgical haemostasis, hemodynamic instability, and cardiac arrest. The procedure is often performed in the intensive care unit (ICU) rather than in the operating theatre (OT). The incidence of chest reexploration may range from 2 to 12%. To analyse the complications of patients who underwent chest reexploration in the ICU for haemostasis after heart surgery vs in those who were operated in an OT. Secondary outcome measured is all-cause mortality in the patients involved. MATERIALS AND METHODS: This is a retrospective analysis of patients' medical records who underwent chest reexploration in the ICU for haemostasis over a 2-year period (2019 to 2020). The cases which needed re-exploration for haemostasis were divided into two groups: cases conducted in those ICU and those conducted in the OT. Complications post-chest re-exploration were measured and categorized into renal failure needing dialysis, pulmonary complication, gastrointestinal complication, heart failure, pericardial effusion, fever, and surgical site infection. RESULTS: 4406 cases of open-heart surgeries were analysed. 351 of the patients underwent chest re-exploration, and majority of the cases were re-explored for haemostasis (88.9%). 64.2% of the chest re-exploration were conducted in the ICU. 21.9% patients who underwent post-chest reexploration in the ICU died, while 13.1% of the patients died post- chest re-exploration in the OT. From the total number of cases of chest re-exploration, 75.9% of patients who had chest re-exploration in the ICU developed complication, whereas patients who developed complication post-chest re-exploration in the OT were 35.1% (p-value < 0.001). CONCLUSION: Chest re-exploration in the ICU for post-cardiacsurgery patients showed a higher percentage of complications, which contributes to mortality.
