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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Kardiochir+Torakochirurgia+Pol
2017 ; 14
(3
): 154-157
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Video-assisted thoracic surgery in hemothorax evacuation after cardiac surgery or
cardiac interventions
#MMPMID29181041
Bashir A
; Daraghma O
; Brzezi?ski Z
; Imie?owski D
; Daszkiewicz P
; Gwo?d? W
; Stupa?a J
; Tomaszewski P
; Kaperczak J
Kardiochir Torakochirurgia Pol
2017[Sep]; 14
(3
): 154-157
PMID29181041
show ga
INTRODUCTION: Cardiac surgery and cardiac interventions are associated with the
risk of iatrogenic complications, including hemothorax. Minimally invasive
methods of evacuating hemothorax include video-assisted thoracic surgery (VATS).
AIM: This paper presents this method and provides its detailed analysis. MATERIAL
AND METHODS: The VATS procedures were used to evacuate hemothorax in 8 patients
(7 after cardiac surgery and 1 after a cardiac intervention). Complete three-port
VATS was performed in 7 patients, while 1 patient underwent assisted VATS due to
a large number of adhesions. RESULTS: On average, the repeat procedures were
performed on the 20th postoperative day (10(th)-58(th) postoperative day). In 6
(75%) cases the VATS intervention was the third surgical intervention performed.
One patient, operated on 12 days after the original procedure, was diagnosed with
active arterial bleeding, which required conversion to a classic procedure using
median sternotomy. No postoperative wound infection was noted. Complete
hemothorax removal was achieved in all patients. CONCLUSIONS: Classic median
sternotomy is the standard approach for hemothorax evacuation. However, it may
sometimes be burdened with a high perioperative risk due to massive mediastinal
adhesions in the late postoperative period. Additionally, access through the
postoperative wound appears to be associated with a higher risk of local
infection and sternal instability. Hemodynamically stable patients in the late
postoperative period, with stable sternums and healed postoperative wounds, are
good candidates for VATS aiming to evacuate hemothorax. The VATS is an effective
procedure for evacuating hemothorax.