Relationship between pleural effusion and pericardial involvement after myocardial revascularization

Area of Science:

• Cardiology
• Thoracic Surgery
• Medical Imaging

Background:

• The etiology of post-cardiac surgery pleural effusion remains unclear.
• A high incidence of left pleural effusion is observed in inflammatory pericardial disease.
• This study investigates the link between pericardial involvement and pleural effusion after coronary artery bypass grafting (CABG).

Purpose of the Study:

• To determine the incidence of pleural effusions post-CABG.
• To assess the relationship between pleural and pericardial effusions after CABG.
• To compare effusion rates between patients receiving saphenous vein grafts (SVG) versus internal mammary artery (IMA) grafts.

Main Methods:

• Prospective study of 47 patients undergoing elective CABG.
• Patients were divided into SVG-only and SVG + IMA groups.
• Chest radiography, ultrasound, and echocardiography were performed on postoperative days 7, 14, and 30.

Main Results:

• High prevalence of both pleural (89.4%) and pericardial (76.6%) effusions at 7 days post-CABG.
• Significant correlation between pleural and pericardial effusions emerged by day 14 (76.6% vs 70.2%) and persisted at day 30 (57.4% vs 53.2%).
• Effusions were more common in the IMA group and tended to be asymptomatic and resolve over time.

Conclusions:

• Post-CABG pleural and pericardial effusions are highly prevalent, often asymptomatic, and resolve gradually.
• Internal mammary artery grafting is associated with a higher incidence of these effusions.
• Persistent pericardial effusion is a predictor of persistent pleural effusion.