Postoperative chest radiographic changes after on- and off-pump coronary surgery

Area of Science:

• Cardiothoracic Surgery
• Diagnostic Imaging
• Radiology

Background:

• Coronary artery bypass grafting (CABG) can lead to various chest radiograph abnormalities.
• Understanding these changes is crucial for patient management post-myocardial revascularization.

Purpose of the Study:

• To compare preoperative and postoperative chest radiograph findings in patients undergoing myocardial revascularization with or without cardiopulmonary bypass (CPB).
• To evaluate the impact of conventional CABG using CPB versus off-pump coronary artery bypass (OPCAB) on chest radiographic outcomes.

Main Methods:

• A comparative analysis of chest radiographs (preoperative, 1 day, 6 days, 6-8 weeks postoperatively) was conducted.
• Two groups of 60 patients each underwent either conventional CABG with CPB or OPCAB surgery.
• Seventeen major potential postoperative abnormalities were assessed on each radiograph.

Main Results:

• Clinical outcomes, including blood loss and intubation time, were significantly better in the OPCAB group.
• The conventional CABG with CPB group showed a significantly higher incidence of left band atelectasis at 6 days postoperatively (37.6% vs. 17.5%, p=0.01).
• No other significant differences in the remaining 16 radiographic findings were observed between the groups.

Conclusions:

• While OPCAB surgery offers improved clinical outcomes compared to conventional CABG with CPB, the radiographic benefit is minimal.
• The primary radiographic advantage of OPCAB is a reduced incidence of left band atelectasis.