Elimination of routine chest radiographs following off-pump coronary artery bypass surgery: A randomized controlled...

Area of Science:

• Cardiothoracic Surgery
• Diagnostic Imaging
• Radiology

Background:

• Routine postoperative chest radiographs (CXRs) are standard practice in many cardiothoracic centers.
• This practice incurs significant costs, manpower, and radiation exposure.
• The necessity of routine CXRs versus clinically indicated ones needs evaluation.

Purpose of the Study:

• To assess early outcomes in off-pump coronary artery bypass (OPCAB) patients comparing routine postoperative CXR protocols with clinically indicated CXR protocols.
• To determine if selective CXR based on clinical indications affects patient outcomes.

Main Methods:

• A randomized clinical trial involving 231 OPCAB candidates.
• Group A (118 patients) received routine postoperative CXRs.
• Group B (113 patients) received CXRs only when clinically indicated.
• All patients were followed up for 30 days postoperatively.

Main Results:

• In the routine CXR group (A), 20 patients had abnormal findings not requiring intervention, with no complications observed during follow-up.
• In the selective CXR group (B), 7 on-demand CXRs led to interventions, and 5 patients had symptomatic complaints, none requiring readmission or further evaluation.
• No complications arose from eliminating routine CXRs.

Conclusions:

• Postoperative chest radiography selection based on clinical grounds instead of routine practice does not alter the early postoperative outcomes of OPCAB procedures.
• This approach can potentially reduce healthcare costs and radiation exposure.
• Selective CXR is a viable alternative to routine postoperative imaging in OPCAB patients.