The early radiologic findings in the adult chest after cardiopulmonary bypass surgery

Postoperative chest radiographs of 70 adults who had undergone cardiopulmonary bypass surgery were evaluated. The distribution of pulmonary collapse/consolidation and pleural effusions, and the patterns of radiopacities related to drainage tubes were considered. Radiologic manifestations related to sternotomy were noted. Cases with a recorded postoperative blood loss of more than 280 ml/hour and/or an increase in mediastinal width of more than 70% had massive mediastinal hemorrhage that required reoperation. Changes in mediastinal contour were inconsistent, although total loss of mediastinal definition suggested hemorrhage or drainage tube blockage. A left apical extrapleural cap indicated massive mediastinal hemorrhage.