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Pulmonary function after coronary artery bypass surgery

F S Vargas1, M Terra-Filho, W Hueb

  • 1Instituto do Coracao of the Faculty of Medicine, University of Sao Paulo, Brazil.

Respiratory Medicine
|March 7, 1998
PubMed
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Coronary artery bypass graft surgery significantly impairs pulmonary function, with forced vital capacity (FVC) dropping sharply post-operation. While FVC gradually recovers, it remains substantially reduced even ten days after surgery.

Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Surgical Outcomes

Background:

  • Coronary artery bypass graft surgery (CABG) is known to negatively impact pulmonary function tests (PFTs).
  • Previous research has explored these changes, but daily serial measurements of forced vital capacity (FVC) post-CABG are lacking.

Purpose of the Study:

  • To evaluate serial changes in FVC following CABG.
  • To identify potential factors influencing FVC reduction after CABG.

Main Methods:

  • Forced vital capacity (FVC) was measured preoperatively and daily for 10 days postoperatively in 120 patients undergoing CABG.
  • Patients were categorized into those receiving only saphenous vein grafts (SVG) and those receiving internal mammary artery (IMA) grafts plus SVG.

Main Results:

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  • Postoperatively, FVC decreased significantly, reaching its lowest point on day 1 (33% of pre-op in SVG group, 29% in IMA group).
  • Although spirometry improved over 10 days, FVC remained reduced (SVG: 70%, IMA: 60% of pre-op).
  • No significant differences in FVC changes were observed between SVG and IMA groups, nor were changes related to age, smoking, anesthesia, or pump time.

Conclusions:

  • CABG leads to significant pulmonary function impairment, with the most severe reduction in FVC occurring immediately after surgery.
  • FVC shows gradual improvement but remains substantially below preoperative levels by day 10.
  • Patients with existing ventilatory impairment should not be excluded from IMA grafting due to only a slight tendency for greater pulmonary function decrease.