title: A prospective study on clinical outcome following pleurotomy during cardiac surgery.
abstract: BACKGROUND
  Due to conflicting reports on pleurotomy-associated morbidity following internal mammary artery (IMA) harvesting, we conducted a prospective study to assess the clinical significance and outcome of pleurotomy during cardiac surgery.
  
  
  METHODS
  We included patients undergoing cardiac surgery from November 2000 until January 2001. Participants were divided into two groups: one with routine or incidental left pleurotomy and the other with intact left pleurae.
  
  
  RESULTS
  Of the 218 patients registered for this study, 12 were excluded (7 deaths occurred, 5 patients were transferred prior to study completion). Of the 206 remaining, 138 had isolated CABG, 39 had valve surgery and 29 had a combined procedure. Although patients with a left pleurotomy (n= 164) had a higher incidence of left lung atelectasis (67.7% vs. 45.2%; p = 0.007), neither radiographic consolidation (7.5% vs. 7.3%; p = 0.96), effusion (42.5%vs. 46.3%; p - 0.66), nor hospital stay (9 days in both groups; p - 0.83) increased.
  
  
  CONCLUSIONS
  Left pleurotomy was found to increase the rate of atelectasis. However, this was not associated with an adverse clinical outcome. Pleurotomy during IMA harvesting can be performed according to operator preference.
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge CB3 8RE, United Kingdom. ericlim2@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Lim
authors.forename: C
authors.initials: C
authors.lastname: Callaghan
authors.forename: R
authors.initials: R
authors.lastname: Motalleb-Zadeh
authors.forename: M
authors.initials: M
authors.lastname: Wallard
authors.forename: N
authors.initials: N
authors.lastname: Misra
authors.forename: A
authors.initials: A
authors.lastname: Ali
authors.forename: J C
authors.initials: JC
authors.lastname: Halstead
authors.forename: S
authors.initials: S
authors.lastname: Tsui
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000209:etiology