Utility of Peri-Operative Chest Radiographs Prior to Elective Cardiac Valve Replacement Surgery: A Retrospective Cohort Study

Abstract

Purpose: Peri-operative chest radiographs (POCXR) are routinely ordered prior to elective valve replacement but there is currently no data to support this practice. We postulated that surgical management was not altered due to these radiographs. Method: The medical records of patients 18 years and over admitted to our institution between 2020 and 2015 for isolated valve replacement surgery were inspected to determine if their management was changed (delayed surgery, new pathology not known etc) due to a POCXR, along with demographic data, chest radiograph findings and other imaging modality data. Results: 208 patients fit the inclusion criteria; all had POCXR. No patients had alteration to surgical timing or procedure based on the POCXR findings. We did find that 4 patients had alterations due to CT findings. 102 patients had CT and POCXR, with 88 patients having a CXR on the same day as or post CT scan. 11 patients had CT findings that warranted further investigation, which was not the case with CXR findings. 4 patients had surgical management altered due to CT scan findings. Conclusions: Our study demonstrated no utility for pre-operative CXR in elective valve replacement surgery. It is noteworthy that CT scanning did change surgical management and further altered medical management in 15 patients. This warrants further investigation.