After cardiac surgery, many complications can arise, in particular at the cardiac and lung level and it is true especially as the patient is with comorbidity. A patient will be considered at risk of a cardiac surgery if risk factors are present in preoperative (obesity, Chronic obstructive pulmonary disease (COPD), etc...). The non-invasive ventilation (NIV)developed these last years in the treatment of acute cardiac insufficiency and the hypercapnic COPD exacerbations; its use is more and more envisaged in cardio-thoracic and abdominal surgery services.

Studies showed that the NIV allowed an improvement of the oxygenation, the lung volumes and a decrease of ventilation work. According to these observations, the preventive NIV could reduce the incidence of appearance of the lung and/or cardiac complications at the patients to risk. we estimate 40 to 50%of cardiac surgery patients at a high risk level and we expect to obtain a benefit with this particular population. If we meet our goal (a significant difference in terms of morbi-mortality with the preventive NIV versus classical care), we expect the systematisation of this procedure to all cardiac surgery high risk patients.

Inclusion Criteria:

Every patient of more than 18 years, programmed for a cardiac surgery ( valve replacement, coronary bypass, aortic surgery) in the service of "Chirurgie Cardio-Thoracique et Vasculaire" (CCTV) of the CHRU of Brest

• and obesity (BMI > 30 kg/m2
• and/or COPD (stages 1-2 and 3, classification GOLD)
• and/or restrictive syndrome (CPT 80 %)
• and/or cardiac insufficiency (FEVG 55 %)
• and/or syndrome of obesity-hypoventilation not requiring an equipment
• and/or Syndrome of sleep apnea not requiring an equipment

Exclusion Criteria:

• Patients having a contraindication absolved from the NIV
• Patients carrier of a neuro-muscular disease
• Patients carrier of a syndrome of sleep apnea and/or COPD, and sailed
• Hypercapnic patients (with a limit value of PaCO2 > 55 mm Hg)
• Unaffiliated patients to a social diet of safety
• Patients under guardianship or under guardianship
• Patient who can not follow the NIV program as well as the patients of whom the consent was not collected.