Dunning Joel, Megahed Mahmood, Millner Russell W J
Blackpool Victoria Hospital, The Department of Cardiothoracic Surgery, Whinney Heys Road, Blackpool FY3 8NR, UK.
Cardiovasc Surg. 2003 Aug;11(4):309-12. doi: 10.1016/S0967-2109(03)00059-0.
A common postoperative complication after CABG with internal mammary artery (IMA) harvest is the evolution of a pleural effusion. Our aim was to see if the intra-operative insertion of a Bellovac drain to the pleural cavity, with drainage continuing for 4-days post operation, eliminates the complication of pleural effusion.
Using our computerised audit database, 500 consecutive patients were identified who had undergone CABG including at least one internal mammary graft by a single consultant at Blackpool Victoria Hospital. All these patients received Bellovac drainage for 4 days on the side of the harvested IMA. The chest X-ray reports were retrospectively collected from the hospital computer databases. The 4-day post-operative, and the 6-week post-operative films were found. In the cases where no consultant radiologist report was found J.D. reviewed the film, and any abnormalities were also reviewed by R.W.J.M.
Out of 500 radiographs, six patients (1.2%) died, 25 patients had no traceable record of a chest X-ray, 434 patients had an entirely normal chest X-ray and 461 patients had no effusion at 6 weeks. Six patients had a small effusion at 6 weeks, two had a moderate effusion successfully treated conservatively, and no patients had a pleural effusion that required drainage.
In patients undergoing coronary arterial bypass grafting with internal mammary artery harvest, the intra-operative insertion of a Bellovac drain on the side of the harvested IMA reduces the risk of postoperative pleural effusions
采用乳内动脉（IMA）进行冠状动脉旁路移植术（CABG）后，常见的术后并发症是胸腔积液的形成。我们的目的是探究术中在胸腔内插入Bellovac引流管，并在术后持续引流4天，是否能消除胸腔积液这一并发症。
利用我们的计算机化审计数据库，识别出500例连续接受CABG的患者，这些患者均由布莱克浦维多利亚医院的一位会诊医生进行手术，且至少使用了一支乳内动脉移植物。所有这些患者在获取IMA的一侧接受了4天的Bellovac引流。胸部X光报告是从医院计算机数据库中回顾性收集的。找到了术后4天和术后6周的X光片。在未找到放射科会诊医生报告的病例中，由J.D.查看X光片，任何异常情况也由R.W.J.M.进行复查。
在500张X光片中，6例患者（1.2%）死亡，25例患者没有可追溯的胸部X光记录，434例患者的胸部X光完全正常，461例患者在6周时没有积液。6例患者在6周时有少量积液，2例有中度积液，经保守治疗成功治愈，没有患者出现需要引流的胸腔积液。
在采用乳内动脉进行冠状动脉旁路移植术的患者中，术中在获取IMA的一侧插入Bellovac引流管可降低术后胸腔积液的风险
