What complications can occur with VAT?
There is a high incidence of dysrhythmias
following tho-racic surgery via open thoracotomy. Dysrhythmias may also occur
following VAT, and may include atrial fibrilla-tion, supraventricular
tachycardia (SVT), and sinus tachy-cardia. Elderly patients and patients who
are receiving digoxin preoperatively may be at greater risk. Risk factors for
postoperative SVT are significant surgical bleeding and increased tricuspid
valve regurgitation as seen on echocar-diography. The use of epidural analgesia
for postoperative pain treatment may be associated with a decrease in the
incidence of dysrhythmias.
Patients may also experience respiratory failure
after VAT, although this is usually more common following thoracotomy with more
extensive resection. Patients with significant pre-existing pulmonary
dysfunction, which can be identified with preoperative pulmonary function
testing, are particularly at risk. The pain following VAT is usually minimal,
which produces less respiratory impair-ment than would a thoracotomy incision.
Other potential complications include bleeding,
infec-tion, and air leak. Although not as common as following thoracotomy, there
may be chronic pain following VAT.
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