Study objectives: To evaluate the safety and efficacy
of smaller-caliber drains in patients undergoing open heart
Design: A retrospective analysis of the
medical records and chest radiographs assembled data on total amount of
drainage, number of days of drainage, length of postoperative stay,
appearance of postoperative chest radiographs, and need for further
drainage from either the pleural or pericardial spaces.
Setting: A large university-based teaching hospital, where>
800 open-heart procedures are performed yearly.
and interventions: A total of 202 patients underwent standard
open heart surgery by one surgeon, and postoperative pleural and
pericardial decompression was undertaken using small caliber, more
flexible drains connected to bulb suction.
Tubes were left in an average of 2.4 days, with a mean of 826.7 mL
collected during that time. The average postoperative length of stay
was 6.7 days (median, 5 days). At or before 6-week follow-up, chest
radiographs revealed moderate or large effusions in 19 patients (9.4%)
in a pleural space that had been drained postoperatively. Twelve
patients (5.9%) required an additional postoperative procedure for
pleural drainage (eight thoracenteses, four tube thoracostomies). Four
patients (2.0%) required reexploration of the pericardium for
Conclusions: Use of smaller-caliber drains
have been found at our institution to be an adequate means of
decompression of the pleural and pericardial spaces following open
heart surgery, with patients rarely having clinically significant
pleural effusions at 6-week follow-up.