ABNORMAL POST-OPERATIVE BLEEDING IN PATIENTS WITH CONGENITAL HEART DISEASES UNDERGOING OPEN HEART SURGERY

Abstract

Objective: To report the incidence of postoperative bleeding and to evaluate perioperative parameters and
its relationship with the volume of blood loss & blood transfusion requirement.
Methodology: This was a retrospective study of 49 patients with congenital heart diseases undergoing open
heart surgery developing abnormal post operative bleeding in Ibn Al-Bitar hospital for cardiac surgery
from January 1st, 2004 to December 31st, 2008, There were 29 males (59%), and 20 females (41%). Age
ranged from 3-38 years with an average of 20 years. The study involved data obtained when the patients
arrived at the intensive care unit (ICU) and for the following 24 hours.
Results: Young children, female gender, lower body weight & surface area, cyanotic heart diseases, types
of procedures, longer time of CPB & aortic clamping time, low temperature, type of oxygenator used in
CPB (affinity), higher total intra- operative doses of heparin & protamine, all were shown to significantly
increase postoperative blood loss & transfusion requirement. The incidence of postoperative bleeding was
9.35%. Twelve percent needed reoperation to control hemorrhage. The morbidity was 24.3% and the
mortality was 4.1%.
Conclusion: Factors that may contribute to increased blood loss and transfusion requirement include age
below 10 years, female gender, low body weight and surface area, prolonged duration of CPB,
hypothermia, preoperative anemia, and high doses of heparin & protamine.