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At the end of every open-heart surgery, surgeons place chest tubes in the surgical spaces to evacuate any post-surgical blood and/or fluid until normal coagulation is restored and hemostasis is achieved. The goal is to evacuate as much of the blood from these spaces as possible before the chemically thinned blood undergoes the phase change from liquid to solid as the coagulation system is restored. Any blood that…

Chest tubes clog after cardiac surgery. This is a known fact that has been acknowledged by 100% of surgeons surveyed, most of whom also report seeing serious adverse complications associated with clogged chest tubes.(1) When chest tubes clog in the presence of post-surgical bleeding, the evacuation of blood from around the heart and lungs can be impaired.

For years, surgeons have been trying to improve the evacuation of post cardiac surgery blood to prevent retained blood complex (RBC). Various permutations of suction drains (anticoagulant coatings, sump-style drains) have been tried, but the problem still remains that the single central lumen clogs with clot and impairs evacuation. (1-3) When this happens, acute complications can ensue, or sub-acute complications can result that slow recovery and contribute to…

All patients have post-surgical bleeding in the early hours after heart surgery. Some patients, depending on the extent of the surgery, comorbidities, or the use of preoperative anti-platelet drugs like Plavix , bleed more extensively than others. Studies have shown that the volume and rate of postoperative bleeding is strongly correlated with negative outcomes.

For years cardiac surgeons have put in large chest tubes, often 36 Fr (12mm, 0.5 inches) in diameter and larger, to evacuate blood from around the heart and lungs after heart surgery. These large diameter tubes have been referred to as garden hoses, and patients are often shocked when they wake up to see these large tubes exiting their bodies. A recent publication by Rahman and colleagues (1)…

  PleuraFlow® Active Clearance Technology™ (ACT) enables clinicians to keep chest tubes clear of clot obstructions, providing superior postoperative blood evacuation, which can reduce Retained Blood Complex (RBC). Learn more about RBC and how PleuraFlow ACT is clearing the pathway to recovery in our new video animation.

Hospitals are well aware that penalties are coming down the pipeline for readmissions after heart surgery. Twenty years ago, financial incentives encouraged programs to discharge patients out of the hospital as quickly as possible after heart surgery. Consequently, the costs shifted to the out of hospital setting, which will no longer be tolerated as the new penalties kick in. How will hospitals and heart teams work together to reduce the potential…