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* From Trakya University Medical Faculty, Departments of Cardiovascular Surgery (Drs. Ege, Canbaz, Cikirikcioglu, Sunar, Ozalp, and Duran) and Cardiology (Dr. Tatli), Edirne, Turkey.
Correspondence to: Turan Ege, MD, Trakya University Medicine Faculty, Department of Cardiovascular Surgery, 22030 Edirne, Turkey; e-mail: turanege{at}ttnet.net.tr
Introduction: To explore the impact of intrapericardial and infracardiac drains on pericardial effusions in cardiac surgery.
Materials and methods: Patients undergoing coronary artery bypass grafting were randomized into two groups. At the end of the intervention, an intrapericardial and infracardiac Blake drain was placed in patients in group 1 (n = 97), and an intrapericardial and infracardiac semirigid drain was placed in patients in group 2 (n = 105). In addition, a semirigid drain was placed into mediastinum in all cases. The amount of drainage was calculated at six different time points postoperatively: postoperative 0 to 2 h, postoperative 2 to 4 h, postoperative 4 to 6 h, postoperative 6 to 12 h, postoperative 12 to 24 h, and postoperative 24 to 48 h. The amount of pericardial effusion was estimated by transthoracic echocardiography after the drains were removed.
Results: In all measurements, the amount of drainage from intrapericardial Blake drains was higher, the total amount of drainage being equal to 330.7 ± 29.4 mL and 193.2 ± 19.6 mL in the Blake drain and semirigid drain groups, respectively (p = 0.000) [mean ± SD]. When the drains were removed, the volume of pericardial effusion was 3.86 ± 0.76 mm in Blake drain group and 7.59 ± 1.16 mm in semirigid drain group (p = 0.000). The incidence of postoperative atrial fibrillation was 11.3% in the group with Blake drains, and 23.8% in the group with semirigid drains (p = 0.016).
Conclusion: The more effective drainage obtained with infracardiac Blake drains compared to semirigid drains helps to reduce the amount of postoperative pericardial effusion and the risk of atrial fibrillation.
Key Words: atrial fibrillation Blake drain pericardial effusion
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N. Roberts, M. Boehm, M. Bates, P. C. Braidley, G. J. Cooper, and T. J. Spyt Two-center prospective randomized controlled trial of Blake versus Portex drains after cardiac surgery. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1042 - 1046. [Abstract] [Full Text] [PDF] |
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