The predictive role of computed tomography on respiratory complications following coronary artery bypass surgery

Abstract

Aim: Pulmonary complications are frequently seen complications following especially after coronary artery bypass grafting. Attempts are made to detect those complications preoperatively by pulmonary function tests and clinical evaluation. In our study, we investigated the effect of computed tomography findings in predicting postoperative complications in patients with normal respiratory function tests. Material and Method: Between January 2012 and August 2017, imaging records, intensive care and service follow-up records, and policlinic follow-up records of 695 patients who underwent elective isolated CABG at the Department of Cardiovascular Surgery in Hitit University Faculty of Medicine were retrospectively reviewed. Computed tomography images, demographic, and clinical data of the patients who met the inclusion criteria were retrospectively evaluated. Results: Mediastinal lymphadenopathy, emphysema, interlobular septal thickness/fibrosis, nodule, pleural thickening, tuberculosis sequel, and band/subsegment alatelectasis parameters were evaluated. The most common preoperative radiologic pulmonary pathology was mediastinal lymphadenopathy (n=96, 27.3%), and the least was tuberculosis sequel (n=20, 5.6%). The most common pulmonary complication in the postoperative period was atelectasis (148 patients, 42%). On logistic regression analysis, emphysema was found to be a significant predictor of both prolonged mechanical ventilation and bronchospasm (p<0.05). Furthermore, band or subsegmental atelectasis were also predictive for postoperative hypoxemia (p<0.05). Discussion: It can be claimed that pulmonary complications are observed frequently after CABG in patients even with normal respiratory function in the preoperative period; morphologic data of lungs obtained by computerized tomography in these patient groups may be predictive for some of the postoperative complications..