A Prospective Study on Clinical Outcome Following Pleurotomy during Cardiac Surgery

Introduction

The internal mammary artery (IMA) is the graft of choice for coronary artery bypass grafting (CABG) due to superior patency and enhanced patient survival [1] [2]. The left internal mammary artery (LIMA) is most commonly used due to its proximity to the left anterior descending artery. Although it is possible to harvest the LIMA without opening the left pleura [3], this cannot be reliably achieved in all cases due to the intimate anatomical relationship.

At our institution, left pleurotomy is performed routinely prior to harvesting the LIMA in order to allow the placement of the LIMA medial to the upper lobe avoiding any undue tension on the mammary pedicle. However, conflicting opinions exist of the effect of pleurotomy on blood loss, postoperative pleural effusion and pulmonary atelectasis [3] [4] [5] [6].

A prospective study was conducted with the aim of assessing the clinical significance and effects on clinical outcome of pleurotomy during cardiac surgery.

References

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