ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
THE EFFECT OF PLEURAL INTEGRITY ON RESPIRATORY FUNCTIONS IN CORONARY ARTERY BYPASS SURGERY
Suat Nail Ömeroğlu, Kemal Uzun, Denyan Mansuroğlu, Hasan Ardal, Murat Bülent Rabuş, Kaan Kırali, Gökhan İpek, Cevat Yakut
Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul
Background:The aim of the study was to evaluate the plerual integrity on pulmonary functions in patients undergone coronary artery bypass grafting.

Methods:Twenty-five patients with intact pleura (Group A) and 25 patients with bilateral opened pleuras (Group B) were compared. Left internal mammary artery was harvested in all patients using the same pedunculated technique. Preoperative and early postoperative (6th day) pulmonary functional tests and postoperative arterial blood gases were evaluated in all patients.

Results:Preoperative data were similar in both groups. Coronary bypass on the beating heart was more frequent performed in Group A than in Group B (7 versus 1; p= 0.024). Cross clamp, total perfusion and operation time were shorter in Group A than in Group B. Postoperative atelectasis and pneumothorax were more frequent detected in Group B than in Group A. Other postoperative findings did not differ statistically between 2 groups. Postoperative FEV1 values decreased significantly in both groups ( p< 0.001 for Group A and p< 0.001 for Group B). FVC values also decreased considerably in the postoperative period ( p< 0.001 for Group A and p< 0.001 for Group B). The similar preoperative FEV1 values ( p= 0.073) in 2 groups did not differ statistically in the postoperative period ( p = 0.22). The FVC values did not significantly differ between 2 groups in both preoperative ( p= 0.085) and postoperative ( p= 0.64) periods. The comparison of the difference between preoperative and postoperative values was not statistically significant. Blood gases and hematocrit values were not different between 2 groups in the postoperative period.

Conclusion:These results show that pleurotomy itself did not affect early postoperative pulmonary functions and arterial blood gases in coronary artery bypass grafting.

Keywords : Pleura, pneumothorax, pulmonary functional test, coronary bypass, blood gas example
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