Post Op Risks

After any open heart operation there is a risk of bleeding that can be significant enough to require return to the operating room for control. The extensive reconstruction of the high-pressure “plumbing” of the aortic root using the delicate material of the pulmonary artery makes this particularly important. Re-exploration for bleeding has been required in only four patients in Dr. Stelzer’s hands. This has not been seen since 1998

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. Most patients receive Aprotinin at the beginning of the operation. This is a powerful medication used appropriately to prevent bleeding in complex cardiac and other operations with a high risk of bleeding.

Major dysfunction of the right ventricle has been seen in four patients due most likely to problems with positioning the right coronary artery. Two of these patients were treated with temporary assist devices (RVAD) for just under a week with excellent outcomes.

Two patients had temporary neurologic dysfunction which resolved completely and one had a true stroke due to a rare clotting abnormality called TTP.

Three patients required several days of extra pulmonary support on a respirator due to lung complications and one other had a pulmonary embolus (blood clot in the lung) which was treated successfully.

The aortic valve is very close to the wiring system of the heart and any operation thereon, especially for aortic stenosis, can result in a condition known as complete heart block. This requires the placement of a cardiac pacemaker. Four patients in this series have received pacemakers for this reason.

Fluid accumulation in the pericardium (sack around the heart) can occur after any heart operation and can interfere with the heart’s function by impairing its ability to fill up between beats. Three patients required drainage of such fluid within a few weeks of surgery.

Temporary kidney dysfunction required dialysis in three patients. None required dialysis after leaving the hospital.

Infection of the incision itself required further surgical treatment in only two patients. Three others had superficial wound drainage that was treated on an outpatient basis. Interestingly, all but one of these patients had combination bypass surgery along with the Ross Procedure.