Radiological Incidence of Unilateral Pulmonary Edema After Minimally Invasive Cardiac Surgery

Abstract

The authors aimed to define the incidence of unilateral pulmonary edema (UPE) within the first 24 hours after minimally invasive cardiac surgery without one lung ventilation techniques based on assessment of chest x-rays. A single-center, retrospective, observational study. A university-affiliated tertiary care center. All consecutive patients >18 years old scheduled for elective minimally invasive cardiac surgery through a right-sided anterolateral minithoracotomy between January 2013 and February 2014 were included. All chest x-rays in the first postoperative 24 hours were assessed by an independent radiologist. Perioperative data were compared using the chi-square test for qualitative data. The Student t test and Mann-Whitney U test, as appropriate, were used for quantitative data. The significant variables were entered into a multiple logistic regression analysis for risk assessment. The study comprised 382 patients (239 men/143 women). Of these, 304 (79.6%) showed normal radiologic findings, 72 (18.8%) showed right-sided pulmonary congestion, and 6 (1.6%) showed right-sided pulmonary edema. Preoperative calcium channel blocker therapy (odds ratio [OR] 3.7), preoperative pathologic right pulmonary vein Doppler profile (OR 3.1), and intraoperative uses of catecholamines (OR 3.2) (95% confidence interval) were independent risk factors for the development of UPE after minimally invasive cardiac surgery. This study showed an incidence of 1.6% of radiologic evident UPE after minimally invasive cardiac surgery. Future prospective studies are needed to validate the effect of the independent risk factors.