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Right pleural versus mediastinal drainage following elective off-pump coronary artery bypass

Author(s): Forouzan nia SKh | Mirhosseini SJ | Moshtaghion SH | Abdollahi MH | Hosseini H | Dehghanizadeh H | Bani fateme SA | Hosseini SM

Journal: Tehran University Medical Journal
ISSN 1683-1764

Volume: 68;
Issue: 12;
Start page: 726;
Date: 2011;
Original page

Keywords: Chest tube | mediastinum | off-pump coronary artery bypass | pleural cavity

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary Artery Bypass (OPCAB) surgery is essential for the prevention of pleural and pericardial effusions, cardiac tamponade and late complications such as constrictive pericarditis. Drainage tubes themselves may induce some complications which can negatively affect the result of the surgery. In this study we assessed a new technique for chest drainage following OPCAB."n"nMethods: In this clinical trial, 171 patients were allocated to two groups. In the control group, the drainage technique included one drain in the left pleural cavity and another in the mediastinum, while in the case group; the drainage technique included one drain in the left plural and one in the right pleural cavity."n"nResults: The amount of drainage in the case group was more than the control group (p=0.001). We found significant reductions in the incidence of arrhythmias in the case group (p=0.005). While one patient (1.2%) needed reoperation for bleeding control in the control group, no patients needed reexploration in the case group (p=0.497). The duration of hospital (p=0.022) and ICU (p=0.002) stays was shorter in the case group."n"nConclusions: Based on the results of this study, changing the position of mediastinal drains in patients undergoing OPCAB surgery and shifting it to the right pleural cavity, reduces complications, such as arrhythmia and pericardial effusion, aside from establishing a better drainage.
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