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Four patients required surgical treatment. Indications, diagnostic procedures and surgical management are discussed. In two patients, thrombosis and fibrosis occurred in the scimitar vein that had been reimplantated in the left atrium, necessitating pneumonectomy.

In a series of 154 patients (116 male and 38 female) with so called pulmonary hamartoma the peak incidence was in the sixth decade, with only three patients less than 20 years of age. Sequential radiographs showed that in 55 patients the tumour first appeared in adult life and that in 53 it progressively increased in size. The age incidence and progressive growth leads to the conclusion that the tumour is a benign neoplasm rather than a hamartoma, consisting of various connective tissues intersected by clefts lined by respiratory epithelium.

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.

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