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Persistent symptomatic pleural effusion following coronary bypass surgery: clinical and histologic features, and

Jean-Christophe Charniot1, Khaled Zerhouni, Marianne Kambouchner

  • 1Department of Cardiology, Hôpital Avicenne, 125 rue de Stalingrad, 93009, Bobigny, France. jean-christophe.charniot@avc.ap-hop-paris.fr

Heart and Vessels
|February 8, 2007
PubMed

Insights

Persistent pleural effusions after coronary artery bypass grafting (CABG) can occur. Video-assisted thoracic surgery (VATS) with talc pleurodesis effectively managed these effusions in three patients, showing no recurrence.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pulmonology

Background:

  • Pleural effusions are common post-coronary artery bypass grafting (CABG), usually resolving spontaneously.
  • A subset of patients develops persistent effusions requiring intervention.

Purpose of the Study:

  • To report the clinical and histological features of persistent post-CABG pleural effusions.
  • To evaluate the efficacy of video-assisted thoracic surgery (VATS) in managing these effusions.

Main Methods:

  • Case series of three patients with persistent pleural effusions within two months post-CABG.
  • Investigation and management via VATS, including pleural biopsy and talc pleurodesis.
  • Histological analysis revealed follicular lymphoid hyperplasia and granulomatous reaction.

Main Results:

  • Effusions were large, predominantly left-sided, and exudative or transudative with lymphocytosis.
  • VATS talc pleurodesis resulted in symptomatic and radiologic improvement in all patients.
  • Mean follow-up of 16.7 months showed no recurrence of pleural effusion.

Conclusions:

  • Persistent large pleural effusions can develop post-CABG, with unclear mechanisms.
  • VATS with talc pleurodesis is a safe and effective treatment for persistent post-CABG pleural effusions.

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