Post Cardiac Surgery Pleural Effusion

Q: Pleural effusion is common at which side in early post coronary artery bypass grafting (CABG) surgery? (select one)  

A) Right 
B) Left


Answer:  B

Early pleural effusions after CABG surgery are usually benign and mostly occur on left side. These are also seen commonly after a heart transplant. In contrast, cardiac valve surgeries are less intent to produce pleural effusions. If the effusion is symptomatic, large and on the right side, it may be a sign of some other underlying disease process (see interesting reference #4 below in this regard).

#pulmonary
#surgicalcriticalcare


References:

1. Vargas FS, Cukier A, Hueb W, et al. Relationship between pleural effusion and pericardial involvement after myocardial revascularization. Chest 1994; 105:1748.

2. Ulubay G, Küpeli E, Er Dedekargınoğlu B, et al. Postoperative Pleural Effusions After Orthotopic Heart Transplant: Cause, Clinical Manifestations, and Course. Exp Clin Transplant 2016; 14:125. 

3. Light RW, Rogers JT, Cheng D, Rodriguez RM. Large pleural effusions occurring after coronary artery bypass grafting. Cardiovascular Surgery Associates, PC. Ann Intern Med 1999; 130:891. 

4. Kunizawa A, Fujioka M, Mink S, Keller E. Central venous catheter-induced delayed hydrothorax via progressive erosion of central venous wall. Minerva Anestesiol 2010; 76:868.