Necessity of Using Pleural Drainage Tubes After IMA Harvesting During Cardiac Surgery

Necessity of Using Pleural Drainage Tubes After IMA Harvesting During Cardiac Surgery

This prospective randomized controlled trial will examine the efficacy of reducing the number of chest tubes used in the postoperative cardiac surgery patient. Typically used are three chest tubes - two in the mediastinum and one in the pleural space, if opened. The investigators propose that removal of the pleural tube will not impact the rates of clinically significant pleural effusions post cardiac surgery. Patients will be randomized into two groups - one receiving the standard three chest tubes (standard), and the other receiving only mediastinal drains (experimental). The primary outcome will be rates of post-operative pleural effusions as determined by defined interventions, including insertion of a chest tube, thoracentesis, or return to the operating room for primary evacuation of pleural effusion or hemothorax. Secondary outcomes include length of hospital stay, length of mechanical ventilation, postoperative respiratory status, and presence/size of pleural effusions, as well as readmission for pleural effusion.

Inclusion Criteria:

• patients must be undergoing CABG at our institution with the attempted harvest of a LIMA and/or RIMA
• pleura must be entered in order for patients to be included.

Exclusion Criteria:

• cardiac surgery where the pleura is not entered
• previous surgery where the pleura was entered
• other pre-existing pleural diseases or fibrosis
• Patients currently participating in other studies
• Patients presenting with emergent need for bypass