The post-cardiac surgery chest radiograph: a clinically integrated approach

The post-cardiac surgery chest radiograph is often read without full knowledge of the patient's pathophysiology or of the specific surgical approach employed. This lack of clinical integration severely limits the effectiveness of the radiologic consultation. This article synthesizes a pathophysiologic foundation for interpretation, drawing on (1) the preoperative physiology and radiographic findings, (2) the events of surgery, cardiopulmonary bypass, and hypothermia, and (3) a detailed survey of the postoperative occurrences and their radiographic presentations including the various appliances, disturbances in fluid balance and ventilation, and complications encountered in the immediate postoperative period. The objective is to define the perioperative events and their radiographic correlations more accurately so that effective radiologic consultation will result.