Abstract
Purpose: Blood loss along with inadequate evacuation after cardiac surgery leads to retained blood syndrome (RBS) in the pleural and/or pericardial cavity. Re-sternotomy is often needed for clot evacuation. Video-assisted thoracoscopic surgery (VATS) evacuation is a less-invasive procedure. However, sufficient evidence on safety and outcomes is lacking.Methods: Thirty patients who developed hemothorax and/or hemopericardium after cardiac surgery and underwent VATS evacuation between April 2015 and September 2020 were included in this retrospective single-center analysis.Results: The median patient age was 70 (interquartile range: IQR 62–75) years, body mass index (BMI) was 24.7 (IQR 22.8–29) kg/m2, time between initial cardiac surgery and VATS was 17 (IQR 11–21) days, 30% of the patients were female, 60% resided in the ICU, and 17% were nicotine users. Coronary artery bypass graft was the most frequent initial cardiac procedure. Median operation time was 120 (IQR 90–143) min, 23% of the patients needed an additional VATS, and the median length of hospital stay after VATS was 8 (IQR 5–14) days. All patients survived VATS, and we experienced no mortality related to the VATS procedure.Conclusion: In our study, VATS for evacuation of RBS after cardiac surgery was a feasible, safe, and efficient alternative approach to re-sternotomy in selected patients.
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