FREQUENCY OF PLEURAL EFFUSION IN CABG SURGERY PATIENTS IN WHOM THE INTERNAL THORACIC ARTERY WAS HARVESTED WITH INTACT PLEURA OR WITH PLEUROTOMY

Abstract

Objective: To determine the frequency of post-operative pleural effusion incoronary artery bypass graft (CABG) surgery patients who underwent internalthoracic artery(ITA) harvesting in whom pleurotomy was performed and inwhom the pleura was intact.

Methodology: A cross-sectional study was carried out from January 2016 toJanuary 2019 at Dow University of Sciences Hospital Karachi. Patients whounderwent elective CABG surgery in whom internal thoracic artery (ITA) graftwas utilized were included. They were divided in two groups. In one grouppatients the ITA was harvested with the pleura being intact and in the secondgroup patients pleurotomy was performed. They were assessed for pleuraleffusion utilizing chest X-ray on the 2nd postoperative day.

Results: From a total of 179 patients in whom the internal thoracic artery (ITA)was harvested, in eighty seveneighty-seven patients the pleura was intact and inninety twoninety-twopatients pleurotomy was performed. In the intact pleuragroup seven patients (8.04%) had pleural effusion. In the pleurotomy group a totalof twenty five (28.26%) patients had pleural effusion. In CABG surgery patientswho underwent ITA harvesting the occurrence of pleural effusion wassignificantly greater in the pleurotomy group (28.26%) compared to the intactpleura group (8.04%) (p<0.05).

Conclusion: In CABG surgery patients who underwent ITA harvesting theoccurrence of postoperative pleural effusion was greater in the pleurotomy groupcompared to the intact pleura group.

Key Words: CABG surgery, Cardiac surgery, Internal thoracic artery, Pleuraleffusion, Pleurotomy.