Long-term results of lung decortication in patients with trapped lung secondary to coronary artery bypass grafting

Ann Thorac Cardiovasc Surg. 2012;18(2):109-14. doi: 10.5761/atcs.oa.11.01715. Epub 2011 Sep 29.

Abstract

Purpose: To evaluate long-term results of decortications in patients with symptomatic restrictive pleurisy and trapped lung after coronary bypass grafting.

Methods: Twenty consecutive patients undergoing lung decortications for trapped lung after coronary bypass grafting were prospectively evaluated. Pulmonary function tests were used as objective criteria, and quality of life was assessed by the Medical Research Council dyspnea scale. A p value <0.05 was considered significant.

Results: Twenty patients, 3 women and 17 men, with a median age of 59 years were evaluated. The median time interval between coronary bypass grafting and decortications was 9.3 months. The mean preoperative forced expiratory volume in one second and forced vital capacity were 63.8% ± 7.4% and 50.5% ± 6.6% of the predicted value, respectively, and the improvement rates after decortications were 14.97% ± 6.3% and 17.62% ± 6.38%, respectively. Dyspnea scores improved after decortications (p <0.05). The median follow-up was 25 months. After surgery, 3 patients developed superficial wound infections, and out of 7 patients with prolonged air leaks, 2 underwent re-operation. After surgery, one patient died on day 34 and another, after 3 years.

Conclusion: Lung decortications, re-expanding the affected lung, ensures symptom remission and improves quality of life of patients with trapped lung after coronary bypass grafting in the long-term.

MeSH terms

  • Adult
  • Aged
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / mortality
  • Dyspnea / etiology
  • Dyspnea / surgery
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Pleurisy / diagnosis
  • Pleurisy / etiology
  • Pleurisy / mortality
  • Pleurisy / physiopathology
  • Pleurisy / surgery*
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Atelectasis / diagnosis
  • Pulmonary Atelectasis / etiology
  • Pulmonary Atelectasis / mortality
  • Pulmonary Atelectasis / physiopathology
  • Pulmonary Atelectasis / surgery*
  • Pulmonary Surgical Procedures* / adverse effects
  • Pulmonary Surgical Procedures* / mortality
  • Quality of Life
  • Recovery of Function
  • Reoperation
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Turkey
  • Vital Capacity