Quadruple Bypass Complications, Low Blood Pressure

[Cristi02]

My Uncle has just undergone quadruple bypass surgery. About two hours after the surgery, he was taken back into surgery because of "complications" that were causing a drop in blood pressure (Staff said maybe due to a blocked artery or a puncture). Does anyone know what types of complications could cause this drop in blood pressure? Is he in serious danger? I am just confused, worried, and trying to understand what's happening to him.

[ed34]

sorry, i seemed to have posted twice in the last one :(
my apologies.

Just to add something else. When  I asked why I was bleeding so much (obviously I had visions of the grafts hanging off), the Doctor said it was simply due to my anticoagulants. So I assume they gave me a good old dose of blood thinners, probably petrol.

[ed34]

"I believe the drain tubes are meant to avoid any contamination getting into the blood stream.  That was my understanding"

If you walk around a cardiac recovery ward, you will see all post CABG patients with drainage tubes going into see through containers on the floor. They all contain blood/fluids and you can see it literally dripping through the tubes. I'm not certain what decides the number of tubes, some only had one. I had three, presumably because it was a triple bypass? After 48 hours the average person ceases to lose any blood/fluids and the tubes can be removed. My BP dropped and I was still losing fluids in the second day and had to be given a blood transfusion. At the end of day three all was well, and the drains were finally removed, along with the pacemaker wire.
My memory isn't too clear on this, but I seem to remember hearing the average person loses about 1300ml of blood? which isn't much at all, just a small amount in the bottom of the container. I got worried when all three were half full which I would guess (by the size of the containers) was around a litre.


Not with a chest drain. They are simply passed into the chest cavity because fluid build up can be quite high. Its not a nice sight seeing three see through canisters on the floor, filling with blood from your chest, obviously mixed with other fluids. I believe the average person has the tubes for 48 hours, over which 1300ml on average is drained. Mine was higher, and due to blood pressure drop I was given a transfusion. thankfully mine settled and the tubes were removed after three days.

[kenkeith]

I had resection of the large bowel years ago, the drainage tube showed bleeding after my first attempt to walk and the bleed was considered significant.  There wasn't any drop in blood pressure, but I was required to take antibiotics for 20 days to avoid sepsis (infection in the blood stream).

I believe the drain tubes are meant to avoid any contamination getting into the blood stream.  That was my understanding....blocked artery or a puncture notwithstanding.  I agree there may not have been a very secure suturing, but I don't believe that would cause a massive bleeding that is required to lowering the blood pressure.

[ed34]

they should know if it was due to a bleed, there are enough drainage tubes coming from the chest. There is always some bleeding, hence the tubes being there, but any excess would be noticed.

[kenkeith]

QUOTE: "(Staff said maybe due to a blocked artery or a puncture). Does anyone know what types of complications could cause this drop in blood pressure? Is he in serious danger? I am just confused, worried, and trying to understand what's happening to him".


>>>>>>>It seems to me if there is leakage at the site of the graft, the bleeding would be substantial and require opening the chest wall, however, often there is a side effect of the anesthesia that causes  blood vessels to dilate throughout the body. Dilation increases the diameter of vessels which increases the blood flow but decreases the pressure at which that blood flows.

Sorry to hear of your father's complications, and hopefully the surgical team was competent enough to have properly secured the graft, and there wasn't any puncture and no need to reopen the chest cavity.

Thanks for sharing, and if you have any followup questions you are welcome to respond. Take care.



Outside influences, such as medications and cardiovascular condition, can also cause a drop in the blood pressure of a surgery patient.

"The cause of low BP are many. There are general categories. There may be not enough circulating blood (e.g. bleeding). The heart may not be pumping adequately (heart attack, heart valve problems, abnormal heart rhythm or rate, the effects of drugs). The blood vessels that hold blood may be open too much ("vasodilation)(allergic reactions, infection, drugs)"

[ed34]

A drop in pressure would likely be caused by a leak where they grafted a vessel. They would have simply found where the leak was and added extra stitches. Fluids or blood transfusion will quickly bring the pressure back up and natural healing will soon ensure those grafts are tightly adhered.