The Death Risk Factors of Patients Undergoing Re-Exploration For Bleeding or Tamponade After Isolate Off-Pump Coronary Artery Bypass Grafting: A Case-Control Study

Abstract Background: The purpose of this study is to analysis the death risk factors of re-exploration for bleeding or tamponade after isolate off-pump coronary artery bypass grafting (OPCABG).Methods: We analyzed the data of 3256 consecutive patients undergoing isolate OPCABG in our heart center from 2013 through 2020. Fifty-eight patients undergonere-exploration after OPCABG. The 58 patients were divided into death group and survival group according to their discharge status, and the risk factors of death were analyzed.Results: The mortality rate was 27.59% (16/58).We found the patients indeath group had higherbody mass index (BMI) (P=0.03), higher cardiac troponin T (cTnT) (P =0.028) and higher incidence of heart failure before OPCABG (P = 0.003). The levels of lactic acid before and after re-exploration (P =0.011 and P <0.001) were higher in death group. And the levels of creatinine (P = 0.003) and partial pressure of carbon dioxide (PCO2) (P = 0.021) were higher in the death group after re-exploration. The death group had longer reoperation time (P = 0.002).In addition, the perioperative utilization rate of intra-aortic ballon pump (IABP) (P = 0.029), continuous renal replacement therapy (CRRT) (P = 0.001) and platelet transfusion (P = 0.009) were higher than survival group. Conclusions: The mortality rate of patients undergoing re-exploration for bleeding or tamponade after isolate OPCABG is high. More attention should be paid to patients withabove risk factors and appropriate measures should be taken in time.