Pleural effusion is a common complication of cardiac surgery, but its characteristics
and predisposing factors should be documented further. Our objective was to determine
the prevalence, characteristics, and determinants of clinically significant pleural
effusions, defined as those requiring therapeutic pleural drainage according to clinical
assessment.
The prevalence and characteristics of patients who had a pleural effusion within 30
days of undergoing coronary artery bypass graft, valve replacement, or both were analyzed
retrospectively at our institution over a 2-year period.
Among the 2,892 patients included in the study (mean age, 66 years; men, 2,139), 192
patients (6.6%) had experienced a clinically significant pleural effusion in the 30
days postsurgery. These effusions occurred after a mean (+/- SD) duration of 6.6 +/-
5.9 days following interventions. Pleural fluid analysis was obtained in 114 patients
(59.4%); all met the criteria for an exudate. Pleural fluid was hemorrhagic in 50%
of cases. Age, body weight, baseline pulmonary function, and smoking status were similar
between patients with and without effusion; however, the proportion of women; the
number of patients with previous conditions of heart failure, atrial fibrillation,
or peripheral vascular disease; and the number of patients receiving therapy with
an anticoagulant or antiarrhythmic agent was higher in the pleural effusion group.
Patients with pleural effusion had an increased prevalence of postoperative complications.
Pleural effusion is a common complication of heart surgery, is associated with other
postoperative complications, and is more frequent in women and in patients with associated
cardiac or vascular comorbidities and medications used to treat those conditions.
ClinicalTrials.gov Identifier: NCT00665015.