Pleural Effusion After Open Cardiac Surgery

Pulmonary complications after cardiac surgery are a major source of morbidity and mortality, as well as increased lengths of hospital stay and resource utilization. Pleural effusion following coronary artery bypass graft surgery (CABG) has been reported in 65% to 89% of cases. The present study was designed to determine the prevalence of pleural effusion after open-heart surgery.

This study evaluated 600 patients who underwent open-heart surgery. The study population was divided into 3 groups: group A consisted of 200 patients who underwent CABG, group B comprised 200 patients who underwent aortic valve replacement (AVR) and mitral valve replacement (MVR), and group C encompassed 200 patients who underwent    valve surgery and CABG. Chest radiography was performed before surgery and afterward on the first, third, and seventh postoperative days.

The study population was comprised of 330 (55%) men and 270 (45%) women. The size of the pleural effusion was small in a large proportion of the patients (45%, n = 270). Additionally, 90 (15%) patients had moderate effusion, occupying between 20% and 40% of the hemithorax, and 84 (14%) patients had large effusion.

Pleural effusion was detected in 37% of the patients after CABG, 25% after valve surgery (MVR+AVR), and 20% after CABG and valve surgery. Most of the cases of effusion after cardiac surgery were left-sided. (Iranian Heart Journal 2020; 21(3): 48-54)