Pulmonary effect of pleurotomy during and after coronary artery bypass with internal mammary artery versus saphenous vein grafts

Burgess, George E.; Cooper, John R.; Marino, Robert J.; Peuler, Martin J.; Mills, Noel L.; Ochsner, John L.

doi:10.1016/s0022-5223(19)41144-6

Cited by 53 publications

(11 citation statements)

References 12 publications

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“…I mpairment of gas exchange after coronary artery bypass graft (CABG) surgery utilizing the left internal mammary artery (LIMA) can complicate the early postoperative period. 1,2 In our department as in others, the LIMA is used as the primary conduit in Ͼ 95% of CABG procedures because of its better patency rate. 3 However, several studies have demonstrated that use of the LIMA leads to changes in pulmonary mechanical behavior and a greater decrease in pulmonary function because of the pain associated with the opening of the pleural space.…”

mentioning

confidence: 85%

“…3 However, several studies have demonstrated that use of the LIMA leads to changes in pulmonary mechanical behavior and a greater decrease in pulmonary function because of the pain associated with the opening of the pleural space. 2 We hypothesized that pain and decreased pulmonary mechanics resulting in reduced pulmonary function may depend on the insertion site of the pleural drain. We therefore compared lung function parameters in patients with the left chest drain placed from the midline (subxyphoid) to patients with standard intercostal drain placement.…”

mentioning

confidence: 99%

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Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Hagl

Harringer

Gohrbandt

et al. 1999

Chest

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mentioning

confidence: 85%

mentioning

confidence: 99%

Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Hagl

Harringer

Gohrbandt

et al. 1999

Chest

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“…Many researchers including Burgess et al stated that harvesting ITA (internal thoracic artery) during CABG surgeries increases complications and makes additional contribution to postoperative pulmonary dysfunction [ 13 - 15 ] . Bonacchi et al [ 10 ] indicated chest tube insertion and pleural injury while preparing ITA graft as the reasons for postoperative poor pulmonary function, which seems to support the findings of some researchers [ 10 , 13 , 16 , 17 ] .…”

Section: Discussionmentioning

confidence: 99%

Effect of postoperative pleural effusion in patients undergoing on-pump CABG

Özülkü¹,

Aygün²

2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveThe present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting.MethodsA total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11.ResultsThe incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006).ConclusionUnder the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

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“…Respiratory abnormalities following cardiac surgery with the use of extracorporeal circulation are well‐documented [5,15–17]. Pulmonary dysfunction after cardiac surgery may be attributable to surgical manipulations including sternotomy [6], harvesting of the internal mammary artery [18,19] and pleurotomy [20]. Possible pulmonary sequelae of CPB are accumulation of extravascular lung water [8], loss of surfactant [11], sequestration of polymorphonuclear leucocytes in the alveolar microcirculation [13] and activation of various mediators as a result of the exposure of blood to non‐endothelial surfaces [21].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of respiratory function before and after cardiopulmonary bypass using side-stream spirometry

Bund

Seitz

Uthoff

et al. 1998

EJA

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Pulmonary impairment is more frequent after cardiac surgery than after other major surgical procedures. The present study investigates whether, by using standard respiratory monitoring, i.e. side-stream spirometry and blood gas analysis, it is possible to detect changes in pulmonary function secondary to cardiopulmonary bypass. We investigated 18 patients undergoing elective coronary bypass surgery or aortic valve replacement. Cardiopulmonary bypass resulted in a nonsignificant increase in alveolar-arterial oxygen difference from 33.0 +/- 10.6 kPa to 36.1 +/- 12.5 kPa and arterial to end-tidal CO2 tension difference from 0.67 +/- 0.39 kPa to 0.79 +/- 0.54 kPa. Respiratory system resistance was unaltered. In contrast, dynamic compliance decreased significantly after cardiopulmonary bypass from 78.6 +/- 22.9 to 65.4 +/- 22.4 mL cmH2O-1 with open chest and from 61.0 +/- 10.2 to 51.1 +/- 17.2 mL cmH2O-1 with closed chest, compared with corresponding values before cardiopulmonary bypass. In conclusion, pulmonary gas exchange was not compromised after cardiopulmonary bypass, but a diminished respiratory compliance was a consistent finding, even in uncomplicated cardiac surgery using routine respiratory monitoring.

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Pulmonary effect of pleurotomy during and after coronary artery bypass with internal mammary artery versus saphenous vein grafts

Cited by 53 publications

References 12 publications

Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Effect of postoperative pleural effusion in patients undergoing on-pump CABG

Monitoring of respiratory function before and after cardiopulmonary bypass using side-stream spirometry

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