|Pleural Effusion after Endovascular
Grafting for Aortic Dissection
(Department of Surgery II, Tokyo Medical University,
|We studied the appearance of pleural
effusion and inflammatory reactions after endovascular grafting
in cases of aortic dissection. From December 1995 to January
2000, 16 patients with chronic double-barrel type aortic dissection
(DeBakey type Vb) were treated by endovascular grafting. In all
cases, enhanced computed tomography (CT) of the chest was examined
before operation and at about the 7th postoperative day (POD).
Patients were divided into 3 groups. Group P: patients who had
pleural effusion before the operation. Group E: patients who
had new pleural effusion after the operation. Group N: patients
who did not have any pleural effusion. In each group, onset of
dissection, patient's age, maximum diameter of dissecting aorta,
period of postoperative fever (above 37.0), and WBC counts and
CRP value at POD 1, 3, 7 and 14 were compared. Four patients
were in group P, 4 patients were in group E, and 8 patients were
in group N. Period between onset and operation was 41.6}34.6months
in group P, 18.2}27.3months in group E and 7.3}11.6months in
group N. There was no relation between the effusion and the period
after onset. Postoperative fever continued for 5.0}2.0 days in
group P, 13.5}2.6 days in group E and 2.5}0.3 days in group N.
The period of fever of group E was significantly longer than
in group N and P (p<0.01). WBC showed a peak on the first
POD in each group. CRP showed a peak value on POD 3 in group
P and N. There was no significance among the 3 groups about WBC
and CRP, but group E showed slightly high CRP values on POD 7
and 14. No patient had complications regarding respiratory function.
After endovascular grafting for aortic dissection, postoperative
pleural effusion appeared in 25% of patients. They had prolonged
postoperative fever, but there was no respiratory function complication.
Endovascular grafting is a minimally invasive procedure with
regard to respiratory function.
@Jpn. J. Cardiovasc. Surg. 31F3-7i2002)