Revision for postoperative bleeding: timing and decision making

Five percent of patients require re-exploration during early postoperative period after open heart surgery. The first cause for early mediastinal re-exploration after open heart surgery is the bleeding. In this review report we evaluated the major risk factors, the decision making for revision and the frequent complications after revision for bleeding under light of the literature. To reduce the risk for bleeding and blood transfusion rates, we recommend that discontinuation of the drugs affecting platelet functions, achievement of shortest CPB time possible, recurrent effective hemostasis before closure and faster elimination of hypothermia after arrival into the intensive care unit.