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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 236

Elimination of routine chest radiographs following off-pump coronary artery bypass surgery: A randomized controlled trial study


1 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran
3 Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Correspondence Address:
Ali Sarvi
Islamic Azad University, Yazd Branch, Medical College, Yazd
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-9175.167966

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Background: Post cardiac surgery routine chest radiographs (CXRs), ordered without any clinical and laboratory indications, is a standard obligatory practice in many cardiothoracic centers. Routine CXRs incur cost, manpower, and radiation. The objective of this study is to assess early outcome in off-pump coronary artery bypass (OPCAB) patients with postoperative routine versus clinically indicated CXR protocols. Materials and Methods: This study is a randomized clinical trial conducted on 231 OPCAB candidates in Afshar Cardiac Center, Yazd, Iran. Patients were categorized into two groups. All 118 patients in group A had routine postoperative CXRs. The 113 patients in group B were selectively exposed to CXR only on clinical indications. All patients were postoperatively followed up for 30 days. Data gathered from both groups were statistically analyzed. Results: Routine postoperative CXRs obtained in 118 OPCAB group A candidates showed abnormal findings in 20 patients that did not require new intervention. One month follow-up of these patients showed no complications. In 113 OPCAB candidates of group B, 7 on-demand CXRs were obtained on clinical evaluation that required added intervention. In a 1-month follow-up of this group, five patients presented with symptomatic complaints. On re-examination, none needed readmission, intervention, or paraclinical evaluation. No complications were observed due to CXR elimination. Conclusion: The study suggests that postoperative CXR selected on clinical grounds in place of routine CXR does not change early postoperative outcome of OPCAB procedure.


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