IMR Press / RCM / Volume 24 / Issue 3 / DOI: 10.31083/j.rcm2403087
Open Access Original Research
Planned Reoperation after Cardiac Surgery in the Cardiac Intensive Care Unit
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1 Department of Cardio-thoracic Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, 210008 Nanjing, Jiangsu, China
2 Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 210023 Nanjing, Jiangsu, China
3 Department of Psychiatry, The First Affiliated Hospital, Zhengzhou University, 450001 Zhengzhou, Henan, China
*Correspondence: (Dongjin Wang)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(3), 87;
Submitted: 19 September 2022 | Revised: 16 November 2022 | Accepted: 6 December 2022 | Published: 8 March 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Cardiac surgical re-exploration for bleeding is associated with increased morbidity and mortality. Whether to perform these procedures in the operating room (OR) or the Cardiac Intensive Care Unit (CICU) in uncertain. We sought to determine if the location of the reoperation would affect postoperative outcomes when a reoperation for bleeding is required following cardiac surgery. Methods: Patients who underwent planned cardiac re-explorations for bleeding at our center from January 2019 to December 2021 were retrospectively enrolled in this study. Patient outcomes were compared and analyzed. Results: Due to hemorrhagic shock, 72 patients underwent planned cardiac re-explorations, including 21 operated in the CICU and 51 in the OR. Within 12 h of the primary operation, 65 re-explorations (90.3%) were performed. The peak Vasoactive-Inotropic Score was 47.0 ± 27.4, systolic blood pressure was 89.4 ± 9.6 mmHg, central venous pressure was 12.1 ± 4.4 cmH2O, and the serum lactate was 5.5 ± 4.1 mmol/L prior to the reoperation. Multivariate logistic analysis showed that a reoperation performed in the CICU was not an independent risk factor for the occurrence of major complications. There was no significant difference in mortality between the two groups. Conclusions: Planned re-exploration for bleeding following open cardiac surgery in the CICU is feasible and safe.

cardiac surgery
cardiac intensive care unit
hemorrhagic shock
Fig. 1.
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