Thoracoscopic talc pleurodesis for recurrent, symptomatic pleural effusion following cardiac operations.
Seventeen patients who underwent a cardiac operation developed a recurrent, symptomatic pleural effusion ultimately requiring video-assisted thoracic surgery (VATS) and talc pleurodesis. These patients represented 0.4% of all patients undergoing a cardiac operation over the same time period. Compared with an age- and sex-matched control group of cardiac surgery patients, patients requiring VATS for recurrent pleural effusion were more obese with higher body mass index (31.9 +/- 1.2 versus 28.3 +/- 1.4 kg/M2, P = 0.03), were more likely to have undergone a complex cardiac operation (8/17 versus 1/17, P =.01) and were more frequently on anticoagulation and antiplatelet agents besides aspirin (8/17 versus 2/17, P =.02). Patients underwent 1.86 +/- 0.34 thoracenteses with drainage of 846 +/- 166 mL/thoracentesis prior to referral for VATS. On average, patients underwent VATS 4.83 +/- 1.49 months after their cardiac operation. There were 3 VATS-related complications (17.6%) and no deaths. VATS talc pleurodesis led to symptomatic and radiologic improvement in all patients with a mean follow-up of 8.2 +/- 1.5 months. VATS talc pleurodesis effectively and safely treats the unusual postcardiac surgery patient with refractory pleural effusion.
Paull
Douglas E
DE
Departments of Cardioghoracic Surgery, Wilkes-Barres General Hospital, Wilke-Barre, PA, USA. dep78@aol.com
Delahanty
Thomas J
TJ
Weber
Fred J
FJ
Harostock
Michael D
MD
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007509:Irritants / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000601:surgery*; D018700:Pleurodesis / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013627:Talc / Q000627:therapeutic use*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome
D007509:Irritants; D013627:Talc