A prospective study on clinical outcome following pleurotomy during cardiac surgery.
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.
Lim
E
E
Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge CB3 8RE, United Kingdom. ericlim2@hotmail.com
Callaghan
C
C
Motalleb-Zadeh
R
R
Wallard
M
M
Misra
N
N
Ali
A
A
Halstead
J C
JC
Tsui
S
S
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