“Are Pleural Effusions Common After Heart Valve Surgery?” Asks Jan
By Adam Pick on October 10, 2009
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!