Chronic obstructive pulmonary disease (COPD) has been conventionally considered as a risk factor for early post-operative morbidity and mortality after open heart surgery.This is an important subject,because COPD and coronary artery disease,which contributes to majority of open heart surgeries, frequently coexist as both are related to smoking. Our objective was to analyse various post-operative pulmonary complications in COPD patients undergoing open heart surgery in relation to the severity of COPD.

A restrospective study of patients who underwent various open heart surgeries between 2010 and 2014 was performed and all were subjected to spirometry.147 patients with a diagnosis of COPD were included in the study and classified as group 1(mild COPD: FEV1/FVC ratio<70%,FEV1≥80%predicted),group2(moderateCOPD:FEV1/FVCratio<70%,50%≤FEV1<80% predicted) and group 3 (severe COPD:FEV1/FVC ratio<70%,FEV1<50% predicted).

Among 147 patients studied,a consistent trend of increasing frequency of postoperative pulmonary complications with advanced COPD stage was noted.Early mortality rate was comparable among the three groups.Patients with severe COPD had a longer hospital stay,length of stay in ICU and need for prolonged ventilation than other groups(P<0.05).Pulmonary infections(pneumonia and bronchitis) were more frequent in severe COPD(25.7%) compared with mild to moderate COPD(11.4%) and controls(11.7%).

The severity of COPD as defined by spirometry can be a prognostic marker in patients undergoing open heart surgery.The incidence of pulmonary infections,length of hospital stay,need for prolonged ventilation were more in patients with severe COPD.