Q: 77 year old male is admitted to ICU as a pre-op for Aortic Valve Replacement. Patient previously had two times CABG (cardiac bypass)  32 year and 15 years ago respectively. Patient's pulmonary function test (PFT), CXR as well as all labs performed as outpatient are under normal parameters. Surgeon requests you to obtain CT scan of the chest. What could be the reason?



Answer: With previous multiple sternotomies, chances of peri-op bleeding may be high. Better understanding of scar  adherences via CT scan of chest in such situations may  help in minimizing  life-threatening surgical bleeding.



Reference:

Morishita K, Kawaharada N, Fukada J, et al. Three or more median sternotomies for patients with valve disease: role of computed tomography. Ann Thorac Surg 2003; 75:1476.