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Chest X-Ray Assessment Interpretation Of Preoperative And Postoperative Cardio Thoracic Ratio.

Introduction . CT Ratio is the transverse cardiac diameter (the horizontal distance between the most rightward and leftward borders of the heart seen on a postero-anterior (PA) chest radiograph) divided by the transverse chest diameter (measured from the inside rib margin at the widest point above t

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Chest X-Ray Assessment Interpretation Of Preoperative And Postoperative Cardio Thoracic Ratio.

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    1. Chest X-Ray Assessment & Interpretation Of Preoperative And Postoperative Cardio Thoracic Ratio. Presented by: Ghassan Al-Dayyat,RT. Queen Alia Heart Institute. King Husein Medical Center.

    2. Introduction CT Ratio is the transverse cardiac diameter (the horizontal distance between the most rightward and leftward borders of the heart seen on a postero-anterior (PA) chest radiograph) divided by the transverse chest diameter (measured from the inside rib margin at the widest point above the costophrenic angles on a PA chest film).

    4. A cardiothoracic ratio of more than 50% is considered abnormal in an adult; more than 66% in a neonate. The cardiac diameter itself can also be measured and, in normal individuals, is less than 15.5 cm in males, and less than 14.5 cm in females. A change in diameter of greater than 1.5 cm between two X-rays is significant.

    5. Objective: To delineate the importance of chest x-rays assessment and interpretation of cardio thoracic ratio.

    6. Prospective Study Over 10 days (Between May7th,2006 and May 16th,2006) A total of 34 Adult patients who underwent open heart surgery at Queen Alia Heart Institute.

    7. 14 (41%) were females 20(59%) were males Mean age 61 (range : 33-77) years Procedures: 23 Aorta Coronary Bypass (ACB) 3 AVR 3 MVR 4 ACB with concomitant AVR and MVR 1 ASD closure. SAMPLES

    8. Preoperative and Postoperative Cardio Thoracic (CT) Ratio were recorded prospectively for each patient. We Assessment Routinely of endotracheal tube position, central lines, chest drains, heart shadow ,lung tissue and plural spaces.

    9. Results

    10. In 11 ( 32.3 %) patients the CT ratio decreased post operatively. 4 following ACB 7 following either valve surgery or ACB+ valve surgery or ASD closure

    11. Post operative bleeding was seen one patient following ACB which showed increased post op CT-ratio, no one of those who had decreased post op CT ratio had evidence of post op bleeding.

    12. Conclusion Pre and post operative CXR assessment and interpretation is important and gives a clue of those who might have post operative bleeding after open heart surgery or other complications such as pneumothorax ,atelactasis or pneumonia.

    13. Fig.2: pneumothorax

    14. Fig. 1 : atelactasis

    15. Fig.3 : pneumonia

    16. Thank you

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