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Published ahead of print on October 11, 2002, doi:10.1164/rccm.200203-184OC

Am. J. Respir. Crit. Care Med., Volume 166, Number 12, December 2002, 1567-1571

A more recent version of this article appeared on December 15, 2002
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Submitted on March 7, 2002
Accepted on October 3, 2002

PREVALENCE AND CLINICAL COURSE OF PLEURAL EFFUSIONS AFTER CORONARY ARTERY AND CARDIAC SURGERY

Richard W Light1*, Jeffrey T Rogers2, J. Phillip Moyers2, Y.C. Gary Lee1, R. Michael Rodriguez1, and Cardiovascular Surgery Associates, PC1

1 Medicine, Vanderbilt University, Nashville, TN, USA; Medicine, Saint Thomas Hospital, Nashville, TN, USA, 2 Medicine, Saint Thomas Hospital, Nashville, TN, USA

* To whom correspondence should be addressed. E-mail: rlight98{at}yahoo.com.

The present prospective study was designed to determine the prevalence of pleural effusion at approximately 28 days post CABG and their subsequent course. This consecutive case study included 389 patients; 312 had only CABG surgery, 37 had both valve and CABG surgery and 40 had only valve surgery. Chest radiographs were obtained approximately 28 days post-operatively. Patients were subsequently contacted by telephone 3, 6, and 12 months post-operatively and questioned concerning the presence of fluid in their chest and related symptoms. The prevalence of pleural effusions in the patients undergoing only CABG surgery (63%) or CABG surgery plus valve surgery (62%) was significantly (p = 0.05) higher than that in the patients undergoing valve surgery only (45%). The prevalence of effusions occupying more than 25% of the hemithorax was 9.7%. The primary symptom associated with these larger effusions was dyspnea. Chest pain and fever were uncommon. Over the 12-month follow-up, the effusions tended to resolve. In conclusion, the prevalence of pleural effusions occupying more than 25% of the hemithorax is approximately 10% 28 days postoperatively. These larger pleural effusions produce dyspnea, but not chest pain or fever and most of the effusions disappear gradually over the subsequent months.
Key words: Pleural effusion, CABG surgery, Dressler's syndrome, dyspnea




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