Evaluation of early postoperative complications after open heart surgery in Hepatitis-B positive patients

Abstract

Introduction: Postoperative course of cardiac surgery patients in presence of liver dysfunction is associated with a lot of complications like excessive bleeding, coagulopathy, hepatic decompensation, multiple organ failure, infections which account for increased mortality and morbidity among this subset of patients. Method: In this study we evaluate early postoperative outcome of elective cardiac surgery in patients with hepatitis B infection. We studied 21 patients with hepatitis B infection who underwent open heart surgery done at department of cardiothoracic surgery, S.M.S Medical college, Jaipur, Rajasthan, India. All preoperative, operative and postoperative data was collected and analysed. Results: Out of 21 patient 13 were operated for coronary artery bypass grafting of these 7 were done offpump and 6 were done onpump. Out of remaining 8 patients 5 were mitral valve replacement for mitral valve disease and 3 were double valve replacement. Out of 21 patients 9 were re-explored for bleeding. Of the total patients operated 5 patients died, of which 1 succumb to renal failure, 3 died due to excessive bleeding and coagulopathy and 1 died due to delayed recovery following cerebral haemorrhage. 6 patients developed sternal wound infection and 2 out of these required sternal rewiring and debridement. Mean hospital stay was around 18 days with mortality of 23.8% and mobidity of around 28.6%. Conclusion: In the study group we found that there is considerable increase in mortality and morbidity among patients with hepatitis B infection that underwent open heart surgery.

Keywords

• Coagulopathy
• debridement
• hepatic decompensation
• multiple organ failures