Safa Göde1, Mehmet Yeniterzi1, Mehmet Kaya1, Muhammet Hulusi Satılmışoğlu1, Salih Güler1, Mehmet Gül2, Serkan Arslan2, Mugisha Markior Kyaruzi1, Murat Sünbül3
1Departments of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Departments of Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
3Department of Cardiology, Medical Faculty of Marmara University, İstanbul, Turkey
Keywords: Cardiac surgery; chest-X-ray; pleural effusion
Objectives: This study aims to investigate possible causes of major pleural effusion in the early period after cardiac surgery.
Patients and methods: Between January 2012 and June 2012; 72 patients with major pleural effusion study group as confirmed by the chest X-ray two weeks after surgery were included. The control group consisted of 68 age- and sex-matched patients with minor or no effusion. Coronary artery bypass graft (CABG), valve replacement (VR), and CABG in combination with VR, the use of internal mammary artery, total perfusion time (TPT), and aortic cross-clamp time (ACCT) were compared between the two groups. The use of antiaggregants, anticoagulants, and diuretics was analyzed.
Results: The development of pleural effusion was found higher in CABG and CABG in combination with VR patients than only VR patients (p=0.007). Among CABG patients, the development rate of pleural effusion was higher in patients with a mammary artery than those with a non-mammary artery (p=0.043). In study group, TPT (p=0.007) and ACCT (p=0.042) were higher than those without pleural effusion. Logistic regression analysis showed that CABG was responsible for the development of major pleural effusion.
Conclusion: Based on our study results, CABG patients seems to be potential candidates for the development of major pleural effusion
compared to VR patients possibly due to pleurotomy, atelectasis, impaired lymphatic drainage, and reduced sternal blood flow. Extended
extracorporeal circulation time may also play a role in the development of pleural effusion through inflammatory responses.