From 1979 to 1993, 79 patients underwent pulmonary resection for lung cancer and a concomitant cardiac operation using extracorporeal circulation. There were 75 men and 4 women with a mean age of 65 years (range 52-77). Cardiac procedures consisted of coronary artery bypass grafting (CABG) in 69 patients (three redos), aortic valve replacement in 7 (2 combined with CABG), mitral valve repair in 1 (combined with CABG) and other in 2. In CABG cases the mean number of distal anastomoses was 4.0. Pulmonary resection included bilateral lobectomy in 1 patient, sleeve lobectomy in 3, pneumonectomy in 6, bilobectomy in 5, lobectomy in 60 and segmental resection in 4. Postoperatively 52 patients were stage I (65.8%), 18 stage II (22.8%) and 9 stage III a. Histology was squamous cell carcinoma in 48 patients (61%) and adenocarcinoma in 24 patients (30%). The hospital mortality was 6.3% (n = 5). Re-exploration for bleeding was necessary in seven patients. Follow-up was complete for all patients. The estimated mean survival for all patients (including hospital deaths) was 58 months. Two- and five-year survival rates were 62% and 42% with 45 and 22 patients, respectively, under surveillance. Lung cancer accounted for 64% of the late deaths. We conclude that pulmonary resection for lung cancer in patients undergoing a concomitant cardiac operation can be performed safely with low operative morbidity and mortality and good long-term survival.
LCNEC is a high-grade neuroendocrine tumor with a poor prognosis. In our patients, after surgical resection or multimodality treatment, all have developed widespread metastatic disease with a rapidly fatal course. Due to the rarity of this tumor, the incidence, prognosis and optimal treatment remain to be determined.
String sign LIMA grafts' were found in 9/52 (17.3%) patients. All patent and all 'string sign grafts' showed a shift towards a coronary flow profile in the proximal segment postoperatively. The study revealed the 'functionality' of the patent and the (distal) 'string sign LIMA graft' in regard to myocardial oxygen demand. 'String sign grafts' are 'recruitable' on demand.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.