Keeping Chest Tubes Clear After Heart and Lung Surgery

A novel chest tube-clearance accessory employs a proprietary active clearance system, which allows surgeons to maintain a functioning chest tube drain in the postoperative period.

The PleuraFlow Active Tube Clearance System is designed to clear chest tubes of clogging material using a magnetic guidewire that advances a clearance member back and forth within the chest tube under sterile conditions, breaking down and pulling clots back out of the tube, leaving the inner portion of the chest tube clear of any obstructing material. The system can be used with standard 32F chest tubes after heart, lung and trauma surgery, or minimally invasive 20F chest tubes, allowing surgeons and nurses to be sure that the tube is open and free of clogging. The system can be put inserted during surgery or added to a PleuraFlow tube after the clogging has begun.


The system is constructed of a shuttle guide set over a guide tube, which is connected to a standard chest drainage system. A magnet is set on the outer side of the tube, while inside the tube is a guide wire set on an internal magnet that morcellates and scoops back the clot debris towards the drainage canister, with the aid of a wire loop at the tip of the guidewire is used to clean the inside of the tube. The external magnetic shuttle drive moves the guide wire inside the chest tube, allowing it to be cleaned without breaking the sterile field. The PleuraFlow system is a product of Clear Catheter Systems (Bend, OR, USA), and has been approved by the US Food and Drug Administration (FDA).

"We envisioned a system that would allow for clots to be mechanically cleared inside chest tubes without breaking the sterile field,” said cardiothoracic surgeon Ed Boyle, MD, founder and CEO of Clear Catheter Systems. "This configuration allows nurses to quickly clear chest tube blockages - even the unseen blockages inside the chest cavity.”

After heart, lung, and chest trauma surgery, fluid or air can accumulate in the chest, which can lead to complications and even death if not properly drained. Chest tubes are the primary mode of drainage, used in nearly all heart and lung surgery cases. They can be inserted in the pleural space around the lungs (pleural tubes) or around the heart (mediastinal tubes), and are connected to a closed drainage system that is attached to a suction pump. Nurses often have to improvise to keep the tubes open by tapping, squeezing, and milking the tubes in an attempt to clear the clots in the postoperative setting; this can be frustrating and time consuming, and is not always successful.

Related Links:
Clear Catheter Systems