Efficacy of Jackson-Pratt Mediastinal Drains in Reducing Pericardial Effusion and Atrial Fibrillation After Coronary Artery Bypass Grafting: A Retrospective Cohort Study.

Abstract

Introduction: Postoperative complications such as pericardial and pleural effusions, cardiac tamponade, and atrial fibrillation (AF) are common after coronary artery bypass grafting (CABG). While standard chest tubes are routinely used for drainage, Jackson-Pratt drains (JP-D) may offer advantages due to their flexible design and ability to maintain negative pressure.

Methods: This retrospective study compared outcomes between patients who received conventional chest tubes drains (CT-D group) (n = 672; 2016 - 2020) and those who received JP-D in addition to standard drains (JP-D group, n = 706; 2020 - 2023) after CABG. Demographic, operative, and postoperative data were collected and analyzed.

Results: Both groups were similar in baseline characteristics (P > 0.05 for all). The JP-D group had significantly lower rates of cardiac tamponade (0.28% vs. 1.78%, P = 0.008), reoperation (1.55% vs. 4.61%, P = 0.001), wound infections (2.1% vs. 4.1%, P = 0.024), 30-day mortality (1.1% vs. 2.0%, P = 0.035), and postoperative AF (9.2% vs. 16.8%, P = 0.039). Despite a higher first-day drainage volume (480 ± 150 mL vs. 360 ± 120 mL, P = 0.030), total drainage volume was similar. Pulmonary complications, including atelectasis and pneumonia, were also significantly reduced in the JP-D group.

Conclusions: The use of JP-D in conjunction with standard thoracic drainage after CABG was associated with improved postoperative outcomes, including reduced effusion-related complications and AF. These findings suggest potential benefits of JP-D in cardiac surgery, though prospective studies are warranted to confirm these results.