“Are Pleural Effusions Common After Heart Valve Surgery?” Asks Jan
Jan just sent me an interesting email about pleural effusions and heart valve surgery.
In her note, Jan writes, “Dear Adam, I am the caregiver of my 59-year old brother who had aortic valve replacement (with a bovine valve) at Vanderbilt University Hospital on July 13, 2009. The valve itself has done okay but he has been in-and-out of the hospital twice since surgery. Fluid continues to collect between his chest wall and right lung. The fluid has been drained twice. Is this common? Thanks, Jan”
It sounds to me like Jan’s brother is experiencing a post-operative complication known as a pleural effusion.
According to The Cleveland Clinic, a pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.
The common symptoms of pleural effusions after heart valve surgery are:
- Chest pain
- Dry, nonproductive cough
- Dyspnea (shortness of breath, or difficult, labored breathing)
- Orthopnea (the inability to breathe easily unless the person is sitting up straight or standing erect)
Specific to Jan’s question, “Are pleural effusions common after heart valve surgery?”, there are about 100,000 total cases diagnosed in the United States each year, according to the National Cancer Institute.
During my research, I learned that pleural effusions are somewhat common after cardiac surgery. Net Wellness suggests, “Post-operative pleural effusions are common in patients who undergo cardiac surgery. Most of these effusions develop as a consequence of the surgical procedure itself and follow a generally benign course.”
Specific to the use of drains to clear the pleural effusions… Karen Kutoloski, Director of the Cardiac Rehabilitation and Assistant Professor at MetroHealth Medical Center, suggests that while pleural effusions can be relatively common, post-operative chest tube drainage is rarely required. Accoring to Kutoloski, most pleural effusions are small and asymptomatic.
I hope this helps answer Jan’s question about fluid in the lungs after heart valve replacement and heart valve repair procedures. Unfortunately, it sounds like Jan’s brother falls into a relatively small category of patients that required fluid drainage after heart valve surgery.
Keep on tickin!
P.S. Did you experience pleural effusions? Did you have fluid drained from your lungs after surgery? If so, please click here to leave a comment.
About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery. This unique book integrates the clinical facts of heart valve surgery with the personal experiences of 78 former valve surgery patients to help patients and caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here.
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October 10th, 2009 at 1:47 pm
I too, experienced a pleural effusion after mechanical valve replacement.. My surgeons colleaque would come in the morning and tell me I was not using the spirometer enough and they were worried about pneumonia.. about 5 days after surgery, they finally called in a lung specialist and after a quick ultrasound, pronounced I had fluid on the lung. It turned out to be blood, not water.. over 1 liter had completely collapsed my left lung. He stated it was a fairly rare event that would not repeat and thus far he is correct. Once they drained the blood, I could finally breath a decent breath in the sprirometer.
October 10th, 2009 at 2:07 pm
I had fluid building up in my abdomen to the point of bloating, taught skin, and discomfort. They put me on a mild duretic and the problem subsided.
October 10th, 2009 at 2:24 pm
Hi, I had descending aortic valve and aneurysm repair on December 2, 2008 at the Cleveland Clinic. I returned to my home in Arizona and was feeling great upon my return, but shortly after New Years, I developed extreme pain in my left shoulder and under my rib cage. I could not get up from my recliner and no matter what I did the pain would not go away. I awoke at 3 a.m. thinking I was having a heart attack. I immediately called for help and was taken to the hospital near my home, It was determined that I had pleural effusion and the new cardiologist attending me wanted to drain the fluid. I explained that the fluid was around my heart when I was discharged from the Cleveland Clinic. I also asked that they call and request my surgical history. The cardiologiist in Cleveland told the cardiologist in Arizona what type of medication to place me on, which is normally given to Gout Patients but which also helped me to got rid of the fluid fairly quick. I felt 100% better within just a few days. I can surely understand how scared pleural effusion is to a patient and caregiver, but as it was mentioned by Adam, it’s very common after heart surgery and usually goes away by itself.
October 10th, 2009 at 4:26 pm
I developed both pleural effusion and effusion around the heart. Both were drained and I felt much better.
October 10th, 2009 at 6:48 pm
One week after surgery to replace my aortic valve, I developed cardiac tamponade. A pericardial procedure was done to drain over a liter of fluid from around my heart. My understanding is that an effusion can develop into tamponade. I remember doing a lot of breathing treatments and other excercises to keep fluid from building up on my lungs.
October 10th, 2009 at 7:17 pm
I too had a left pleural effusion after about 10 days. I had been recovering very well and it was like I had hit the wall. I had 800ml drained to no effect and diuretics which also did nothing. After a frustrating week I saw my surgeon who said I should ignore the previous advice to take things easy and really push the exercise until I was well out of breath - it cleared up within a few days!
October 10th, 2009 at 8:35 pm
My experience was very similar to one of your other responders. I had aortic valve replacement (bovine) on a Tuesday morning. In recovery the doctor explained that they almost had to take me back to surgery for excessive bleeding. After a transfusion they finally got the bleeding to stop. On Wednesday they gave me another transfusion. They were concerned that I still required some oxygen by Saturday night so a pulmonary doctor did a sonogram and said my right lung was collapsed due to fluid. He did a thoracentesis and removed 1 liter of blood. I was off all oxygen by the next afternoon and discharged on Monday.
October 11th, 2009 at 1:44 am
I also experienced a pleural effusion after mitral valve replacement in July or 2000. I was readmitted to the hospital, a drainage tube inserted and stayed for a week while draining litre upon litre of fluid. The fluid added 35 to 40 pounds of very uncomfortabel weight. Fortunately I left the hospital and my cardiologist took over my care and eliminated that problem along with other complications. This is the first I’ve heard that this is pretty common after the surgery. I have aortic stenosis now and hope I will not need another replacement. Isn’t there some way to prevent the chance of a pleural effusion?
October 11th, 2009 at 9:59 am
4 weeks after my triple bypass on sept 1 they removed a quart from my chest cavity. thinking I had pneumonia they kept me in hospital for three days and then sent me home. they tried to culture the fluid but no bacteria materialized. for three days they loaded me with cypro anf other anibiotics. the thirty something doctor was convinced I had pneumonia no matter the lab results. I was saved by my cardiologist who intervened and basically told the other doctor that this was normal for heart patients. it has been a month sice this happened and the fever has not returned and I have a small amount of fluid around my left lung. I was told this may or may not go away.
October 11th, 2009 at 4:26 pm
I had a bovine aortic replacement at the Cleveland Clinic on October 30,2009 and returned to my home in Florida about 1 week later. I developed a severe cough and was hospitalized for a large pleural effusion and underwent a thorosentesis which drained about 1 liter of fluid with blood, Between mid November and mid Dec. I had 2 more pleural effusions which were draided on an out patient basis. Each procedure drained less and I have had no further prolems with this since De. I was told that pleural effussions are commom post aortic replacement and occurs at some level in >60% of patients. I was told that this hyper fluid response is caused by the lungs being deflated during the surgery and can sometimes recur up to 1 year post surgery.
October 12th, 2009 at 7:44 pm
I was just reviewing my medical records from surgery to repair my mitral valve two months ago. I was startled to see a report of “bilateral pleural effusion” and a bit relieved that it appears to be somewhat common after heart surgery. I have no symptoms that seem to be consistent with pleural effusion, but will follow up with my cardiologist to make sure that this is nothing that I need to have monitored.
October 12th, 2009 at 9:02 pm
I had aortic valve relacement surgery in November, 2008. Surgery and recovery were successful and quite uneventful EXCEPT for recurring pleural effusion and 3 thorocentesis (drainage) procedures. I have significant shortness of breath upon stair-climbing, walking any distance or exerting most physical activity. Pulmonologist is still trying to come up with some beneficial treatment. A definite downer that no one mentions PRIOR to surgery.
October 14th, 2009 at 8:42 pm
Hi Adam
I’m experiencing pleural effusion of about 550 cc’s or 1 pint of fluid. I believe it showed up on day 3 after surgery and included the right chest pain and nagging cough. I was slated for an aspiration but then my surgeon decided to put me on diuretics to see if that would help. I was sent home and told to have my family physician monitor the progress. I’ve been home a week now and today notice my cough has lessened a little and perhaps I’m turning a corner. Let’s hope tomorrow is better. I was also sent home with a Flovent prescription which may have helped. While in CCU one other valve patient underwent an aspiration procedure which didn’t look to be too pleasant. I’m really thinking that is the source of the acute pain in my right back.
I asked my family physician today to double check on my right lung and she couldn’t really understand why I was asking. I’m going to monitor how I feel myself and perhaps tomorrow if I can’t definitely see improvement, will insist she see me. I’d rather be safe than sorry. Perhaps I’m not explaining the symptoms correctly but I know that is what is noted on my discharge papers including the request for family physician follow-up and x-ray.
I don’t mind discomfort but I would worry if there were any dangers involved that I should be aware of.
Cheryl, Ontario
October 18th, 2009 at 6:06 pm
Adam,
I had my aortic valve replaced with an On-X mechanical valve July 16, 2009. I am a 50 year old male born with a bicuspid aortic valve. About 2 weeks after surgery, I was starting to feel a little “off” even though my recovery was going well and I had been keeping up with my walking. Late one night I asked my wife to drive me to the ER to get checked out. Something wasn’t right but I had no idea what was wrong. Providentially I had an aggressive ER doc at the Lehigh Valley Hospital, Allentown PA who fortunately found the problem: Pericardial Effusion. They admitted me right away and was back in the OR by 11 am that day. I did have the pericardial cavity drained and they put another chest tube in. I was in the hospital for another 4 days. So I lost about a week on my recovery schedule. My suggestion to your readers: if your not feeling right and you’re not getting answers or not getting a response from your medical care givers, be politely persistent. I am 13 weeks post op and feeling great. Jim
November 2nd, 2009 at 1:39 pm
Adam, I had plureal effusion after my aorta valve replacement in Feb. 2009. I had a lot of difficulty breathing and severe pain in my back shoulder blade area on the right and a cough I could not shake. The home nurse diagnosed it before any of my drs. agreed finally. Once the chest x-ray came back I had to go and have the effusion drained, which was relatively painless and fast to my surprise and relief.
I was told that this is very rare after cardiac surgery. I ended up with the effusion again about 3 wks. later but not enough to drain. Ended up clearing on its own this time. I was surprised to get this due to I was constantly up moving after surgery and during my recovery at home for 6 wks. I am only 48yrs. old.
November 8th, 2009 at 12:44 pm
hi, ive just two months ago underwent bypass surgery to repair two blocked arteries, two weeks afte released from the hospital, i had to go in and have fluid drained from both lungs,,,there was close to a qt. of fuild in each side,,,i felt so much releaf, then two weeks later i had to go again,,,not as much fluid in the right lung but still close to a qt on the left lung,,,now this is three weeks after the last time and ive got to go in and have the fluid drained again,,,they told me friday that i only had the left side with fluid, the right has none…im wondering if this will stop or am i in for this every two or three weeks…