A prospective study on clinical outcome following pleurotomy during cardiac surgery

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Surgical Morbidity

Background:

• Conflicting reports exist regarding morbidity associated with pleurotomy during internal mammary artery (IMA) harvesting.
• A prospective study was initiated to clarify the clinical significance and outcomes of pleurotomy in cardiac surgery.

Purpose of the Study:

• To prospectively assess the clinical significance and patient outcomes associated with pleurotomy during internal mammary artery (IMA) harvesting.
• To evaluate the impact of left pleurotomy on specific morbidities following cardiac surgery.

Main Methods:

• A prospective study enrolled patients undergoing cardiac surgery between November 2000 and January 2001.
• Patients were categorized into two groups: those with a left pleurotomy (routine or incidental) and those with an intact left pleura.
• Data analysis compared outcomes between the two groups, including atelectasis, consolidation, effusion, and hospital stay.

Main Results:

• Of 206 eligible patients, 164 underwent left pleurotomy.
• Patients with left pleurotomy showed a significantly higher incidence of left lung atelectasis (67.7% vs. 45.2%; p = 0.007).
• No significant differences were observed in radiographic consolidation (p = 0.96), effusion rates (p = 0.66), or hospital stay (p = 0.83) between the groups.

Conclusions:

• Left pleurotomy during internal mammary artery (IMA) harvesting is associated with an increased rate of atelectasis.
• This increased atelectasis did not translate to adverse clinical outcomes or prolonged hospital stays.
• The decision to perform pleurotomy during IMA harvesting can be based on surgeon preference.