الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
CABG is still one of the most durable and effective means of revascularization for patients with coronary heart disease either on pump or off pump coronary artery bypass(OPCAB),despite the other novel alternatives for coronary artery revascularization.
The use of antiplatelet agents at the time of CABG carries both benefits and risks. The drugs are effective in reducing ischemic events in high-risk patients awaiting surgery,. However, antiplatelet drugs also aggravate perioperative bleeding followed by increased postoperative blood loss, increased transfusion requirements, and hemodynamic instability.
Postoperative severe bleeding is relatively common following cardiac surgery compared to other surgical specialties and is considered a serious complication associated with increased morbidity and mortality. Within the cardiac surgery population, patients with advanced age and prolonged cardiopulmonary bypass (CPB) time are especially at risk of postoperative bleeding. Moreover, it is well known that excessive bleeding may be caused by surgical factors and impaired haemostasis due to enhanced fibrinolysis, platelet dysfunction, haemodilution, acidosis, hypothermia, and consumption of coagulation factors.
Here we study the incidence, risk factors, and outcomes in patients undergoing re-exploration for bleeding after coronary artery bypass graft surgery.
This prospective study was performed on 212 patientswho had primary elective on pump CABG surgery at chark Al Madina hospital during one year from 2013 to 2014 and were divided into two groups according to the incidence of re-exploration. Detailed history taking, full laboratory investigations were done and excluding any coagulation defects or any risk factor for bleeding in the studied patients.